Family viva questions in community medicine in by examiner in mbbs 3rd year
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Here is a thorough, exam-ready set of Family Viva Questions in Community Medicine for MBBS 3rd Year, organized by topic exactly as examiners approach them:
Family Viva Questions - Community Medicine (MBBS 3rd Year)
1. Definition and Concept of Family
- Define family. What is the difference between a family and a household?
- What is a nuclear family? Give examples.
- What is a joint family? What are its health implications?
- What is a broken family / disorganized family?
- Define family size and family composition.
- What is the Kuppuswamy classification of socioeconomic status? How do you calculate the score?
- What is the BG Prasad classification? How is it updated for current prices?
- What is the Modified Udai Pareek scale?
2. Family Cycle (Duvall's Family Life Cycle)
- What is the family life cycle? Describe its stages.
- At which stage is the family most vulnerable to health problems?
- What are the health tasks of the family at each stage?
3. Functions of Family
- What are the biological/reproductive functions of a family?
- What are the psychological functions?
- What are the social and economic functions?
- How does family structure affect child health and nutrition?
4. Family as a Unit of Study
- Why is the family used as a unit in community medicine?
- What is meant by family-centered care?
- What is a family health record?
- What is a family folder? What documents does it contain?
- What is a genogram? Draw a sample genogram.
- What is a pedigree chart? How does it differ from a genogram?
5. Family Study (Direct Examiner Questions)
These are the most commonly asked in the viva, especially if you've done a family study:
- Why did you select this family for study?
- What is the socioeconomic status of this family? How did you calculate it?
- What health problems did you identify in this family?
- What are the felt vs. unfelt needs of the family?
- What health education did you give to the family?
- How did you assess nutritional status of members?
- Was immunization up to date? What schedule did you follow?
- Did any member have a communicable disease? How was it managed?
- What environmental health problems were present (water, sanitation, housing)?
- How do you assess housing - what is the Dunlop index? What is overcrowding?
- What is a latrine - what types exist (pucca, kachha, septic tank)?
6. Socioeconomic Assessment Tools
| Scale | Based on |
|---|---|
| Kuppuswamy | Education + Occupation + Income |
| BG Prasad | Income (per capita) only - updated with CPI |
| Modified Udai Pareek | Rural families |
- How do you update BG Prasad scale to current year? (CPI correction)
- What is the difference between poverty line and socioeconomic classification?
7. Family Planning
- Define family planning.
- What is the National Family Planning Programme in India? When was it launched?
- What is the small family norm?
- Name the spacing and limiting methods of contraception.
- What is Pearl Index? How is it calculated?
- What are natural methods of family planning (LAM, rhythm, safe period)?
- What are barrier methods? (Condom, diaphragm, cervical cap)
- What is an IUCD (intrauterine contraceptive device)? Types?
- What are oral contraceptive pills? Combined vs. progestin-only?
- What is emergency contraception? When is it indicated?
- What is Medical Termination of Pregnancy (MTP) Act 1971? Key provisions?
- What is vasectomy vs. tubectomy? What is no-scalpel vasectomy (NSV)?
- What are the contraindications to IUCD?
- What is DMPA (Depo-Provera)?
- What is Centchroman (Saheli) - the Indian oral contraceptive?
8. Reproductive and Child Health (RCH)
- What is the RCH Programme? What did it replace (earlier MCH)?
- What is ANC (antenatal care)? What are the 3 trimesters and their visits?
- What are the danger signs in pregnancy?
- What is safe motherhood? What are the three delays?
- What is MMR (Maternal Mortality Rate) of India? Target under SDG?
- What is IMR (Infant Mortality Rate)? Current India figure and target?
- What is neonatal mortality rate vs. perinatal mortality rate?
- What is kangaroo mother care?
- What is JSSK (Janani Shishu Suraksha Karyakram)?
- What is JSY (Janani Suraksha Yojana)? Eligibility?
- What is PMSMA (Pradhan Mantri Suraksha Matritva Abhiyan)?
9. Immunization
- What is the National Immunization Schedule (UIP) for children?
- What is herd immunity? What is the threshold?
- What is cold chain? Describe the cold chain system.
- What is a VVM (Vaccine Vial Monitor)?
- What is the open vial policy?
- What is AEFI (Adverse Event Following Immunization)?
- Differentiate active vs. passive immunization.
- What is Mission Indradhanush? What are its goals?
- What is Pulse Polio immunization?
10. Nutrition
- What is PEM (Protein Energy Malnutrition)? Types (Kwashiorkor, Marasmus)?
- What is Gomez classification of malnutrition?
- What is IAP classification?
- What is MUAC (Mid-Upper Arm Circumference)? Cut-off values?
- What is ICDS (Integrated Child Development Services)? Beneficiaries?
- What is nutritional surveillance?
- What is anemia - causes in children and pregnant women? Cut-off Hb values?
- What is IDA, VAD, IDD (iodine deficiency disorder)?
- What is the National Nutritional Programme?
11. Health Indicators of a Family
Be ready to quote current national figures:
| Indicator | Approx. India Figure |
|---|---|
| IMR | ~28/1000 live births (2020) |
| MMR | ~97/100,000 live births (2018-20) |
| TFR | ~2.0 (2019-21) |
| Life expectancy | ~70 years |
| Under-5 mortality | ~32/1000 live births |
12. Environment and Housing
- What is overcrowding? Define by cubic space and floor space.
- What is the Dunlop overcrowding index?
- What are types of water supply and safe sources?
- What is sanitation? Types of latrines for rural areas?
- What is the Swachh Bharat Mission?
- What is ODF (Open Defecation Free)?
13. Tips for Viva Performance
- Always present your family study clearly: name of head of family, family type, socioeconomic class, major health problems found.
- Know how you calculated the SES (Kuppuswamy/BG Prasad) - show the math.
- Quote current national health indicators - examiners love checking if you know MMR, IMR, TFR.
- Know all government schemes related to MCH: JSY, JSSK, PMSMA, Mission Indradhanush, ICDS.
- Genogram drawing: be able to draw it with standard symbols on the spot.
- Pearl Index formula: Pearl Index = (Number of failures × 1200) / Total months of exposure.
These cover the vast majority of questions asked in MBBS 3rd year community medicine family viva examinations across Indian universities. Focus especially on your own family study details, the SES calculation, immunization schedule, and national health programmes - those are the areas examiners probe most deeply.
With answers
Here are all the key Family Viva Questions with Answers for Community Medicine, MBBS 3rd Year:
Family Viva - Questions with Answers
Community Medicine | MBBS 3rd Year
SECTION 1: Definition and Concept of Family
Q1. Define family.
A: A family is a group of biologically related individuals living together and sharing a common kitchen. It is the basic social unit of society.
- WHO definition: "A family is a group of persons united by ties of marriage, blood or adoption, constituting a single household, interacting with each other in their respective social roles."
Q2. Difference between family and household?
A:
| Family | Household |
|---|---|
| Related by blood, marriage, or adoption | May include unrelated persons living together |
| Share common kitchen | Share common dwelling |
| Biological/social bond | Economic/residential bond |
| Example: parents + children | Example: paying guests, friends sharing a flat |
Q3. Types of families?
A:
- Nuclear family - Husband, wife, and unmarried children (most common in urban areas)
- Joint family - Three or more generations living together (grandparents, parents, children)
- Extended family - Nuclear family + other relatives (uncle, aunt)
- Single-parent family - One parent with children
- Broken family - Family disrupted by divorce, separation, or death
- Reconstituted/Blended family - Remarried parents with children from previous marriages
- Childless/Dyadic family - Couple without children
Q4. Functions of a family?
A:
- Biological function - Reproduction, continuation of species
- Psychological function - Emotional security, identity, mental health
- Social function - Socialization of children, social norms
- Economic function - Financial security, sharing of resources
- Educational function - Primary education and values
- Cultural/Religious function - Transmitting culture, traditions
- Protective function - Care of sick, elderly, and children
Q5. What is the family life cycle (Duvall's)?
A: Duvall described 8 stages:
| Stage | Description |
|---|---|
| 1 | Beginning family (married couple, no children) |
| 2 | Childbearing family (first child born) |
| 3 | Family with preschool children (child 2.5-6 yrs) |
| 4 | Family with school-age children (6-13 yrs) |
| 5 | Family with teenagers (13-20 yrs) |
| 6 | Launching family (first child leaves home) |
| 7 | Middle-age family (empty nest to retirement) |
| 8 | Aging family (retirement to death of both spouses) |
SECTION 2: Socioeconomic Classification
Q6. What is Kuppuswamy's Socioeconomic Scale?
A: Used for urban families. Based on 3 parameters:
1. Education of head of family (1-7 points)
2. Occupation of head of family (1-10 points)
3. Monthly family income (updated with CPI annually) (1-12 points)
Total score and classification:
| Score | Class |
|---|---|
| 26-29 | Upper (I) |
| 16-25 | Upper middle (II) |
| 11-15 | Lower middle (III) |
| 5-10 | Upper lower (IV) |
| <5 | Lower (V) |
Q7. What is BG Prasad Classification?
A: Based on per capita monthly income only. Used for general/both urban and rural.
Updated using Consumer Price Index (CPI) for Industrial Workers:
Formula to update: Take the original income limits (from 1961 base year) and multiply by:
Current CPI / Base year CPI (1960 = 100)
Classes: I (Upper), II (Upper Middle), III (Middle), IV (Lower Middle), V (Lower)
Q8. What is Modified Udai Pareek Scale?
A: Used for rural families. Parameters include:
- Occupation
- Education
- Land ownership
- Housing type
- Material possessions
- Social participation
SECTION 3: Family Study
Q9. What is a family folder?
A: A family folder is a collection of health records maintained for each family registered at a health sub-centre or PHC. It contains:
- Family identification card (name, address, family members)
- Individual health cards for each member
- Antenatal/postnatal records
- Immunization records
- Survey forms
Q10. What is a genogram?
A: A genogram is a pictorial representation of a family's relationships and medical history across generations (like a family tree but with health data).
Standard symbols:
- Square = Male
- Circle = Female
- Horizontal line = Marriage
- Vertical line = Children
- X through symbol = Deceased
- Double line = Consanguineous marriage
- Dotted circle/square = Adopted
Q11. What is a felt need vs. unfelt need?
A:
| Felt Need | Unfelt Need |
|---|---|
| Problem perceived by the family themselves | Problem identified by health worker but not recognized by family |
| Example: "My child has fever" | Example: Family doesn't know they need ORS for diarrhoea prevention |
| Family may seek care on their own | Needs health education and counseling |
SECTION 4: Family Planning
Q12. Define family planning.
A: Family planning is the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of births. It is achieved through use of contraceptive methods and treatment of infertility.
Q13. What is Pearl Index?
A: Pearl Index is a measure of contraceptive effectiveness.
Formula:
Pearl Index = (Number of unintended pregnancies × 1200) / Total months of exposure
- Lower the Pearl Index = more effective the method
- Ideal Pearl Index = 0
- Condom PI ≈ 2-12; OCP PI ≈ 0.1-1; IUCD PI ≈ 0.5-1
Q14. What are the methods of family planning?
A:
A. Spacing methods (temporary):
- Natural methods - Rhythm/calendar, LAM (Lactational Amenorrhoea Method), safe period, coitus interruptus
- Barrier methods - Male condom, female condom, diaphragm, cervical cap, spermicides
- Hormonal - Combined oral contraceptive pills (COCPs), progestin-only pills (POPs), DMPA injection, implants
- Intrauterine devices (IUCD) - CuT 380A, LNG-IUS (Mirena)
- Emergency contraception - Levonorgestrel 1.5 mg within 72 hours, IUCD within 5 days
B. Limiting methods (permanent/terminal):
- Male - Vasectomy (conventional or no-scalpel vasectomy)
- Female - Tubectomy (Pomeroy's, Fimbriectomy, Laparoscopic sterilization)
Q15. What is No-Scalpel Vasectomy (NSV)?
A:
- NSV is a minimally invasive surgical technique for male sterilization
- A sharp pointed forceps is used to puncture the scrotal skin instead of a scalpel
- Vas deferens is isolated, a segment removed, and ends ligated
- Advantages: No stitches needed, less bleeding, less infection, faster recovery, quicker to perform
Q16. What is LAM (Lactational Amenorrhoea Method)?
A: LAM is a natural contraceptive method based on 3 conditions - ALL 3 must be met:
- Mother is exclusively breastfeeding (no supplements, no water)
- Baby is less than 6 months of age
- Mother has not resumed menstruation (amenorrhoea)
- When all 3 conditions met: 98% effective
- Once any condition fails, another method must be used
Q17. What is the MTP Act 1971?
A: Medical Termination of Pregnancy Act was passed in 1971 and amended in 2021.
Key provisions:
- MTP can be done up to 20 weeks with opinion of 1 registered medical practitioner (RMP)
- Up to 24 weeks for special categories (rape survivors, minors, disabled women) - requires 2 RMPs
- Beyond 24 weeks: Only with Medical Board approval (for substantial fetal abnormality)
- Must be performed in a government hospital or certified private facility
- 2021 Amendment: Upper limit extended from 20 to 24 weeks for special categories; Medical Board introduced
Q18. What is Centchroman (Saheli)?
A:
- Indigenous Indian oral contraceptive pill developed by CDRI, Lucknow
- Non-steroidal (orally active selective estrogen receptor modulator - SERM)
- Dose: Once a week for 12 weeks, then once in 2 weeks (fortnightly)
- Advantages: Very few side effects (no estrogen-related effects), safe for lactating mothers, reversible
- Pearl Index: ~1.6
SECTION 5: Reproductive and Child Health
Q19. What is ANC (Antenatal Care)?
A: ANC is the care given to a pregnant woman from conception until the onset of labor.
Minimum recommended visits (WHO): 8 contacts (revised 2016)
India (traditional): At least 4 visits
Components (3 T's + others):
- TT (Tetanus Toxoid): 2 doses or booster (now Td vaccine)
- Tab Iron-Folic Acid (IFA): 100 mg iron + 500 mcg folic acid daily for 180 days
- Tab Calcium: 1 g/day from 2nd trimester
- Blood pressure monitoring
- Weight monitoring
- Abdominal examination (fundal height, fetal heart)
- Urine examination (protein, sugar)
- Blood tests (Hb, blood group, VDRL, HIV, blood sugar)
Q20. What is MMR? What is India's current MMR?
A:
- MMR (Maternal Mortality Ratio) = Number of maternal deaths per 100,000 live births
- India's MMR: ~97 per 100,000 live births (SRS 2018-20)
- SDG target: <70 per 100,000 live births by 2030
- Leading causes: Hemorrhage, sepsis, hypertensive disorders, obstructed labor, unsafe abortion
Q21. What is IMR? What is India's current IMR?
A:
- IMR (Infant Mortality Rate) = Number of deaths in infants (under 1 year) per 1000 live births
- India IMR: ~28 per 1000 live births (SRS 2020)
- Components:
- Neonatal mortality rate (NMR) = deaths under 28 days
- Post-neonatal mortality rate = deaths from 28 days to under 1 year
- Early NMR (0-7 days) + Late NMR (7-28 days)
Q22. What are the three delays in maternal mortality?
A: The Three Delays Model (Thaddeus & Maine, 1994):
- Delay 1 - Delay in deciding to seek care (due to lack of recognition of danger signs, social/cultural factors, financial constraints)
- Delay 2 - Delay in reaching care (poor transport, bad roads, long distance to facility)
- Delay 3 - Delay in receiving adequate care (inadequate staff, drugs, equipment at health facility)
Q23. What is Janani Suraksha Yojana (JSY)?
A:
- Cash transfer scheme under National Health Mission (NHM)
- Promotes institutional delivery among BPL and other vulnerable pregnant women
- Cash incentive:
- Rural BPL: ₹1400 (woman) + ₹600 (ASHA)
- Urban BPL: ₹1000 (woman) + ₹400 (ASHA)
- Eligibility: BPL women, SC/ST women (in high-performing states: all women)
SECTION 6: Immunization
Q24. What is the National Immunization Schedule (UIP)?
A:
| Age | Vaccine |
|---|---|
| At birth | BCG, OPV-0, Hepatitis B (birth dose) |
| 6 weeks | OPV-1, Pentavalent-1 (DPT+HepB+Hib), IPV-1, Rotavirus-1, PCV-1 |
| 10 weeks | OPV-2, Pentavalent-2, Rotavirus-2, PCV-2 |
| 14 weeks | OPV-3, Pentavalent-3, IPV-2, Rotavirus-3, PCV-3 |
| 9-12 months | Measles-Rubella (MR-1), JE-1 (endemic districts), Vitamin A |
| 16-24 months | MR-2, DPT booster-1, OPV booster, JE-2, Vitamin A |
| 5-6 years | DPT booster-2 |
| 10 years | Td |
| 16 years | Td |
| Pregnant women | Td (2 doses or 1 booster) |
Q25. What is herd immunity?
A:
- Herd immunity is the indirect protection from an infectious disease that occurs when a sufficient proportion of a population has become immune through vaccination or prior infection, thereby reducing the spread to unimmunized individuals.
Herd immunity threshold (HIT):
HIT = 1 - (1/R0)
Where R0 = Basic reproduction number
| Disease | R0 | HIT |
|---|---|---|
| Measles | 12-18 | ~94% |
| Polio | 5-7 | ~80-85% |
| COVID-19 | 2-3 | ~60-70% |
Q26. What is a Vaccine Vial Monitor (VVM)?
A:
- VVM is a heat-sensitive label attached to a vaccine vial
- It changes color (inner square darkens) when cumulative heat exposure is excessive
- Helps detect cold chain breaks
- 4 stages: Stage 1 (usable), Stage 2 (usable), Stage 3 (discard point), Stage 4 (discard)
- Rule: If inner square is same or darker than outer circle = DISCARD
Q27. What is Mission Indradhanush?
A:
- Launched in December 2014 by Government of India
- Goal: Achieve 90% full immunization coverage in children and pregnant women
- Targets unvaccinated and partially vaccinated children
- Intensified Mission Indradhanush (IMI) - multiple sub-phases launched to boost coverage
- Vaccines covered: All UIP vaccines
SECTION 7: Nutrition
Q28. What is Kwashiorkor? How does it differ from Marasmus?
A:
| Feature | Kwashiorkor | Marasmus |
|---|---|---|
| Cause | Protein deficiency (adequate calories) | Total calorie + protein deficiency |
| Age | 1-3 years (after weaning) | Under 1 year |
| Edema | Present (pitting edema) | Absent |
| Appearance | Pot belly, moon face | Wasting, "old man face," "baggy pants" |
| Hair changes | Flag sign, depigmentation | Present but less prominent |
| Skin | Flaky paint/crazy pavement dermatosis | Loose, wrinkled |
| Appetite | Poor | Good |
| Fatty liver | Present | Absent |
| Serum albumin | Very low | Low |
Q29. What is Gomez Classification of malnutrition?
A: Based on weight for age (% of standard/median):
| Grade | % of expected weight for age |
|---|---|
| Normal | >90% |
| Grade I (mild) | 75-90% |
| Grade II (moderate) | 60-74% |
| Grade III (severe) | <60% |
Q30. What is MUAC? Cut-off values?
A:
- MUAC = Mid-Upper Arm Circumference - measured at the midpoint of the left upper arm
- Reflects muscle mass and fat stores
- Quick field screening tool for malnutrition in children 6-59 months
| MUAC | Interpretation |
|---|---|
| ≥13.5 cm | Normal (GREEN) |
| 12.5-13.4 cm | Moderate Acute Malnutrition - MAM (YELLOW) |
| <12.5 cm | Severe Acute Malnutrition - SAM (RED) |
For pregnant women:
- <23 cm = at risk of malnutrition
Q31. What is ICDS?
A: Integrated Child Development Services - launched in 1975. Largest child nutrition programme in the world.
Beneficiaries:
- Children 0-6 years
- Pregnant and lactating mothers
- Adolescent girls (under SABLA scheme)
6 services provided (SNIHE + 2):
- Supplementary nutrition
- Immunization
- Health check-up
- Referral services
- Pre-school non-formal education
- Nutrition and health education
Delivery point: Anganwadi Centre (AWC) run by Anganwadi Worker (AWW)
SECTION 8: Environment and Housing
Q32. Define overcrowding. How is it assessed?
A: Overcrowding is defined as a situation where too many people occupy a living space inadequate for comfortable and healthy habitation.
Methods of assessment:
-
By floor space standard:
- < 50 sq ft per person = overcrowded
- Recommended: ≥100 sq ft for adults
-
By cubic space:
- < 500 cubic ft per person (old British standard) for adults (350 for children)
-
By persons per room:
-
2 persons per room = overcrowded (common Indian definition)
-
-
Dunlop index:
- Also called Standard of Living index; considers persons per room
Q33. What is safe drinking water? What are the standards?
A:
- WHO standard for drinking water: Coliform count = 0 per 100 ml (zero coliform organisms)
- BIS (India) standard: pH 6.5-8.5, Turbidity <1 NTU, Total dissolved solids <500 mg/L
- Safe sources: Piped treated water, protected wells, boreholes
Test for water purity: Coliform bacteria test (E. coli as indicator organism)
SECTION 9: Key Health Indicators to Quote
| Indicator | India Figure (approx.) |
|---|---|
| Infant Mortality Rate (IMR) | 28/1000 live births (SRS 2020) |
| Neonatal Mortality Rate (NMR) | 20/1000 live births |
| Maternal Mortality Ratio (MMR) | 97/100,000 live births (2018-20) |
| Total Fertility Rate (TFR) | 2.0 (NFHS-5, 2019-21) |
| Life expectancy at birth | ~70 years |
| Under-5 mortality rate (U5MR) | 32/1000 live births |
| Crude Birth Rate (CBR) | ~19.7/1000 population |
| Crude Death Rate (CDR) | ~6.2/1000 population |
| Institutional delivery rate | ~88.6% (NFHS-5) |
| Full immunization coverage | ~76.4% (NFHS-5) |
SECTION 10: Quick-Fire One-Liners (Examiner Favorites)
- Crude Birth Rate = Live births per 1000 mid-year population
- TFR = Average number of children a woman would have if she lived through reproductive age applying current age-specific fertility rates
- GFR = Live births per 1000 women aged 15-49 years
- Safe period = Days 1-7 and 21-28 of a 28-day cycle (unsafe = days 8-20)
- ASHA = Accredited Social Health Activist - 1 per 1000 rural population
- Sub-center = covers 5000 population (3000 in hilly/tribal areas)
- PHC = covers 30,000 population (20,000 in hilly/tribal areas) - First point of contact
- CHC = covers 1,20,000 population - has 30 beds, specialist services
- Anganwadi = covers 400-800 population
- MO at PHC = Medical Officer in charge, 1 per PHC
These answers cover the full depth and breadth expected in a 3rd year MBBS community medicine family viva. Know your own family study details cold - that is where most examiners begin, and your answers there set the tone for the entire viva.
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