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Based on the BHMS university exam pattern (especially the 10 x 2 = 20 marks short notes section that appears consistently in previous year papers), here is a focused topic list:
PSM Important Topics - BHMS University Exam (20 Marks)
The 20-mark section in BHMS PSM exams typically consists of 10 short notes of 2 marks each. These are 1-2 line definition/concept answers. Below are the highest-frequency topics organized by unit.
🔹 Concept of Health & Disease
| Topic | What to Know |
|---|---|
| Definition of Health (WHO) | "Complete physical, mental, social well-being, not merely absence of disease" |
| Iceberg Phenomenon | Visible (clinical) vs hidden (subclinical) disease - disease like iceberg mostly submerged |
| Quarantine | Restriction of movement of healthy contacts for maximum incubation period |
| Herd Immunity | Resistance of a group to attack due to immunity of proportion of members |
| Epidemiology | Study of distribution and determinants of health-related states in populations |
🔹 Epidemiology & Biostatistics
| Topic | What to Know |
|---|---|
| Cohort Study | Prospective study - follow exposed & unexposed groups to see disease development |
| Case Control Study | Retrospective - compare cases (disease) vs controls (no disease) |
| Incidence vs Prevalence | Incidence = new cases; Prevalence = all existing cases |
| Sensitivity & Specificity | Ability of test to detect true positives/negatives |
| Modes of Transmission | Direct (droplet, contact) & Indirect (vehicle, vector, airborne) |
| Census | Complete enumeration of population - done every 10 years in India |
🔹 Environment & Water
| Topic | What to Know |
|---|---|
| Sewage | Wastewater from domestic, commercial, industrial sources |
| Large Scale Water Purification | Sedimentation → Coagulation → Filtration → Chlorination |
| Chlorination | Disinfection of water; residual chlorine = 0.5 mg/L after 1 hr contact |
| Hardness of Water | Due to Ca/Mg salts; temporary (removed by boiling) & permanent |
| Insecticides | DDT, BHC (organochlorines); Malathion (organophosphate); Pyrethrum (botanical) |
| Mosquito Control | Anti-larval (oiling, larvicides), anti-adult (spraying), biological, environmental |
| Blocked Flea | Xenopsylla cheopis - plague vector; blocked due to Y. pestis growth in proventriculus |
| Cyclops (disease) | Dracunculiasis (Guinea worm) - transmitted by Cyclops (water flea) |
🔹 Nutrition
| Topic | What to Know |
|---|---|
| Balanced Diet | Diet containing all nutrients in adequate proportions for normal body function |
| Food Fortification | Adding nutrients to food (e.g., iodine in salt, Vit A in oil) |
| Food Adulteration | Adding inferior/harmful substances to food; governed by FSSAI |
| Nutritional Problems in India | PEM, Anaemia, Vit A deficiency (Xerophthalmia), Iodine deficiency, Rickets |
| PEM | Protein Energy Malnutrition - Kwashiorkor (protein) & Marasmus (calories) |
🔹 Communicable Diseases
| Topic | What to Know |
|---|---|
| BCG Vaccine | Live attenuated vaccine - given at birth, protects against TB |
| Vaccination Schedule (UIP) | BCG, OPV, Hep-B at birth; DPT, IPV, Hep-B at 6/10/14 wks; Measles at 9 months |
| Polio Epidemiology | Feco-oral route; India eradicated in 2014; IPV + OPV used |
| Rabies | Zoonotic - dog bite; Negri bodies; post-exposure prophylaxis (PEP) |
| Modes of Intervention | Primordial, Primary, Secondary, Tertiary prevention |
🔹 Reproductive & Child Health / National Programs
| Topic | What to Know |
|---|---|
| Eligible Couple | Married couple where wife is 15-45 years (reproductive age) |
| Hormonal Contraceptives | Combined OCP (estrogen + progestin); DMPA (injectable); Norplant (implant) |
| NRHM / NHM | National Rural Health Mission (2005); now National Health Mission covering rural + urban |
| ICDS | Integrated Child Development Services - nutrition, immunization, health checkup for under-6 |
🔹 Occupational Health & Miscellaneous
| Topic | What to Know |
|---|---|
| Pneumoconiosis | Lung fibrosis due to dust inhalation; Silicosis (silica), Asbestosis, Byssinosis (cotton) |
| Hospital Waste Management | Color coding: Yellow (anatomical), Red (recyclable), Blue (glass), Black (general) |
| Disaster Management | Mitigation → Preparedness → Response → Recovery (PPRR cycle) |
| Socio-Economic Classification | Modified BG Prasad / Kuppuswamy scale - based on education, occupation, income |
📌 Top 10 Most Repeated 2-Mark Topics (Memorize First)
- Definition of Health
- BCG Vaccine
- Quarantine
- Balanced Diet
- Census
- Blocked Flea
- Eligible Couple
- Sewage
- Modes of Transmission of Disease
- Pneumoconiosis
Exam tip: For 2-mark answers, write 2-3 lines - one definition line + one key feature/example. Never write more than 4 lines. For the 20-mark section, speed and accuracy matter more than depth.
Communicable diseases which is more imp According to university examination
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Here is the complete breakdown of most important Communicable Diseases for BHMS PSM university exam, ranked by frequency of appearance across papers:
Communicable Diseases - BHMS PSM Exam (Most Important)
🥇 TIER 1 - Most Repeated (Almost Every Year)
1. TUBERCULOSIS (TB)
Most asked topic - comes as long essay or short note
| Point | Detail |
|---|---|
| Agent | Mycobacterium tuberculosis |
| Source | Sputum-positive patient (droplet nuclei) |
| Transmission | Airborne - droplet nuclei (most common) |
| Pathology | Primary complex in lung, Ghon focus |
| Tuberculin test | Mantoux test - >10mm = positive |
| Diagnosis | Sputum AFB, CBNAAT/Gene Xpert, X-ray |
| Treatment | DOTS - Cat I: 2HRZE + 4HR |
| Prevention | BCG vaccine at birth, RNTCP/NSP |
| Programme | National Tuberculosis Elimination Programme (NTEP) - target elimination by 2025 |
Probable questions: Epidemiology of TB / Tuberculin test / BCG vaccine / DOTS / RNTCP
2. MALARIA
Highest yield vector-borne disease
| Point | Detail |
|---|---|
| Agent | P. vivax (benign tertian), P. falciparum (malignant tertian - most dangerous) |
| Vector | Female Anopheles mosquito (bites at night) |
| Transmission | Bite of infected female Anopheles |
| Clinical | Fever with chills & rigors, splenomegaly |
| Diagnosis | Peripheral blood smear (gold standard), RDT, PCR |
| Treatment | Chloroquine (P. vivax), ACT - Artemisinin (P. falciparum) |
| Prevention | ITN (Insecticide Treated Nets), IRS (Indoor Residual Spraying), larvicides |
| Programme | National Vector Borne Disease Control Programme (NVBDCP) |
Probable questions: Epidemiology of malaria & its control / Vector control methods / NVBDCP
3. POLIO
Eradication success story - always asked
| Point | Detail |
|---|---|
| Agent | Poliovirus (enterovirus) - Type 1, 2, 3 |
| Transmission | Feco-oral route (most common), respiratory |
| Reservoir | Humans only |
| Clinical | 90% silent; <1% flaccid paralysis |
| Diagnosis | Stool culture (gold standard), serology |
| Vaccine | OPV (oral - Sabin) + IPV (injectable - Salk) |
| India status | Polio-free since January 2011, certified 2014 |
| Programme | Pulse Polio Immunization - "Do Boond Zindagi Ki" |
Probable questions: Epidemiology of polio & prevention / Pulse Polio Programme
4. DIPHTHERIA
Repeatedly asked as long essay in BHMS (Rajiv Gandhi University papers)
| Point | Detail |
|---|---|
| Agent | Corynebacterium diphtheriae (Klebs-Loeffler bacillus) |
| Transmission | Droplet infection, direct contact |
| Pathology | Pseudomembrane in throat, exotoxin causes cardiac & neural damage |
| Diagnosis | Schick test (for susceptibility), culture, Albert stain |
| Treatment | Diphtheria Antitoxin (DAT) + Penicillin/Erythromycin |
| Prevention | DPT vaccine (3 doses), DT booster |
| Schick test | +ve = susceptible; -ve = immune |
Probable questions: Detail Diphtheria / Schick test / DPT vaccine
🥈 TIER 2 - Frequently Asked (Short Notes / Short Essays)
5. TYPHOID (Enteric Fever)
| Key Points | Detail |
|---|---|
| Agent | Salmonella typhi |
| Route | Feco-oral (5 F's - Flies, Fingers, Food, Fluid, Fomites) |
| Clinical | Step-ladder fever, rose spots, relative bradycardia |
| Widal test | O antigen (current infection), H antigen (past/vaccine) |
| Carrier | Chronic carrier (most important source - Mary Mallon "Typhoid Mary") |
| Vaccine | TAB vaccine, Vi capsular polysaccharide vaccine |
| Treatment | Ciprofloxacin, Ceftriaxone |
6. CHOLERA
| Key Points | Detail |
|---|---|
| Agent | Vibrio cholerae O1 (El Tor biotype) |
| Transmission | Contaminated water & food (feco-oral) |
| Clinical | "Rice water" stools, severe dehydration, painless |
| Treatment | ORS (mainstay) + Tetracycline/Doxycycline |
| Prevention | Safe water, proper sanitation, OCV (Oral Cholera Vaccine) |
| Notification | Notifiable disease under IHR |
7. RABIES
| Key Points | Detail |
|---|---|
| Agent | Rhabdovirus (Lyssavirus) |
| Source | Dog bite (90% in India); also cat, bat, monkey |
| Pathology | Negri bodies in hippocampus (pathognomonic) |
| Incubation | 2-8 weeks (range 10 days to 1 year) |
| PEP | Wound wash → ARV (3/5 doses) → RIG if required |
| Pre-exposure | 3 doses of HDCV |
| 100% fatal once symptoms appear |
8. HEPATITIS B (Serum Hepatitis)
| Key Points | Detail |
|---|---|
| Agent | HBV - DNA virus, Hepadnaviridae |
| Transmission | Blood & blood products, sexual, vertical (mother to child) |
| HBsAg | Surface antigen - marker of infection |
| HBeAg | Marker of infectivity (high viral load) |
| Anti-HBs | Protective antibody |
| Vaccine | 3 doses (0, 1, 6 months); given at birth under UIP |
| Chronic | >6 months = chronic HBV; risk of cirrhosis & HCC |
9. PLAGUE
| Key Points | Detail |
|---|---|
| Agent | Yersinia pestis |
| Vector | Blocked flea - Xenopsylla cheopis (rat flea) |
| Reservoir | Rats (Rattus rattus) |
| Types | Bubonic (most common), Pneumonic (most dangerous), Septicaemic |
| Blocked flea | Y. pestis blocks proventriculus → flea bites repeatedly → transmission |
| Treatment | Streptomycin (drug of choice), Doxycycline |
| Notifiable | International quarantinable disease |
10. MEASLES
| Key Points | Detail |
|---|---|
| Agent | Paramyxovirus |
| Transmission | Most infectious - droplet spread |
| Koplik's spots | Pathognomonic - on buccal mucosa before rash |
| Vaccine | MR/MMR vaccine at 9 months and 15-18 months (under UIP) |
| Complications | Pneumonia (most common cause of death), encephalitis, SSPE |
| Control | Herd immunity needed = >95% vaccination coverage |
🥉 TIER 3 - Short Notes (2 marks)
| Disease | 1 Key Point |
|---|---|
| Chickenpox | Varicella-zoster; highly infectious; vesicular rash in crops |
| Leprosy | M. leprae; neural & skin involvement; MDT (Multi Drug Therapy); eliminated 2005 |
| Filariasis | Wuchereria bancrofti; Culex mosquito; lymphedema; DEC drug |
| Dengue | Flavivirus; Aedes aegypti (day biting); thrombocytopenia; no vaccine approved in India |
| Japanese Encephalitis | Flavivirus; Culex mosquito; JE vaccine under UIP |
| Tetanus | Clostridium tetani; exotoxin (tetanospasmin); TT vaccine; risus sardonicus |
| Whooping Cough (Pertussis) | Bordetella pertussis; "whoop" cough; DPT vaccine |
| AIDS/HIV | HIV (Retrovirus); CD4 <200 = AIDS; NACO programme; ART treatment |
📌 Priority Order for Exam Preparation
MUST PREPARE (Long Essays):
1. Tuberculosis (TB) + NTEP
2. Malaria + NVBDCP
3. Diphtheria
4. Polio + Pulse Polio
SHORT NOTES (5 marks):
5. Typhoid / Widal test / Typhoid Mary
6. Cholera / ORS
7. Rabies / PEP
8. Hepatitis B / HBsAg
9. Plague / Blocked flea
10. Measles / Koplik spots
2-MARK DEFINITIONS:
11. Leprosy / MDT
12. Dengue / Aedes
13. HIV/AIDS
14. Tetanus / TT vaccine
Exam strategy: For any communicable disease, always cover - Agent → Transmission → Diagnosis → Treatment → Prevention/Vaccine → National Programme. This 6-point framework works for any 5-mark or 15-mark answer.
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