Assistant Director Inspection (Medical) Past Papers (2020-2026)
Questions
Assistant Director (Healthcare Regulation / Inspection) – MBBS + MPH
200 Important Questions with One-Line Answers (Basic to Advanced)
PART A – PUBLIC HEALTH & EPIDEMIOLOGY (Q1–50)
Question No.1: What is the WHO definition of health? Ans: A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.
Question No.2: Which conference introduced Primary Health Care and the goal “Health for All by 2000”? Ans: The Alma-Ata Conference (1978).
Question No.3: Which conference renewed the commitment to Primary Health Care in 2018? Ans: The Astana Declaration (2018).
Question No.4: Which charter defined health promotion in 1986? Ans: The Ottawa Charter.
Question No.5: What are the levels of prevention? Ans: Primordial, primary, secondary, tertiary and quaternary.
Question No.6: What is an example of secondary prevention? Ans: Early diagnosis and treatment, such as screening.
Question No.7: Who is called the father of modern epidemiology? Ans: John Snow (Broad Street cholera outbreak, London, 1854).
Question No.8: What is incidence? Ans: The number of new cases in a population at risk during a specified period.
Question No.9: What is prevalence? Ans: All existing cases (old and new) in a population at a given time.
Question No.10: What is the relation between prevalence and incidence? Ans: P = I × D (prevalence = incidence × mean duration).
Question No.11: What is the denominator of the Infant Mortality Rate? Ans: 1,000 live births.
Question No.12: What is the denominator of the Maternal Mortality Ratio? Ans: 100,000 live births.
Question No.13: What is the Crude Birth Rate? Ans: Live births per 1,000 mid-year population.
Question No.14: What is the case fatality rate? Ans: Deaths from a disease divided by total cases of that disease, × 100.
Question No.15: What is sensitivity? Ans: The ability of a test to correctly identify those with disease: TP / (TP + FN).
Question No.16: What is specificity? Ans: The ability of a test to correctly identify those without disease: TN / (TN + FP).
Question No.17: What is Positive Predictive Value (PPV)? Ans: TP / (TP + FP); it rises with disease prevalence.
Question No.18: Which study design gives the relative risk? Ans: Cohort study.
Question No.19: Which study design gives the odds ratio? Ans: Case-control study.
Question No.20: Which study design is the gold standard for evaluating interventions? Ans: Randomized Controlled Trial (RCT).
Question No.21: What sits at the top of the hierarchy of evidence? Ans: Systematic reviews and meta-analyses of RCTs.
Question No.22: What is attributable risk? Ans: Incidence in the exposed minus incidence in the unexposed.
Question No.23: What is Number Needed to Treat (NNT)? Ans: 1 / Absolute Risk Reduction.
Question No.24: Who proposed the criteria for causation? Ans: Sir Austin Bradford Hill (1965).
Question No.25: What is a confounder? Ans: A third variable associated with both the exposure and the outcome that distorts the true association.
Question No.26: What is the best way to control confounding at the design stage? Ans: Randomization.
Question No.27: What is the purpose of blinding in trials? Ans: To reduce observer and participant bias.
Question No.28: What is selection bias? Ans: A systematic error arising from how study participants are selected.
Question No.29: What is the herd immunity threshold? Ans: 1 − 1/R₀.
Question No.30: What is the approximate R₀ of measles? Ans: 12–18.
Question No.31: What is an epidemic? Ans: The occurrence of cases clearly in excess of normal expectancy.
Question No.32: What is an endemic disease? Ans: A disease constantly present at a usual level in a given area.
Question No.33: What does a point-source epidemic curve look like? Ans: A single sharp peak with all cases occurring within one incubation period.
Question No.34: What is the first step in outbreak investigation? Ans: Verifying the diagnosis and confirming that an outbreak exists.
Question No.35: What is surveillance? Ans: The ongoing systematic collection, analysis, interpretation and dissemination of health data for action.
Question No.36: When did Pakistan’s EPI program start? Ans: 1978.
Question No.37: In which two countries does wild poliovirus remain endemic? Ans: Pakistan and Afghanistan.
Question No.38: When was Pakistan’s Lady Health Worker Programme launched? Ans: 1994.
Question No.39: What is the cold chain temperature for most vaccines? Ans: +2°C to +8°C.
Question No.40: What is DOTS? Ans: Directly Observed Treatment, Short-course, the WHO TB control strategy.
Question No.41: What is DALY? Ans: Disability Adjusted Life Year = YLL + YLD.
Question No.42: What is QALY used for? Ans: Cost-utility analysis; it combines quantity and quality of life.
Question No.43: What is ICER? Ans: Incremental Cost-Effectiveness Ratio = difference in cost ÷ difference in effect.
Question No.44: Which SDG relates to health? Ans: SDG 3: Good Health and Well-being.
Question No.45: What are the WHO six building blocks of a health system? Ans: Service delivery, health workforce, health information, medical products and technologies, financing, and leadership/governance.
Question No.46: What is Universal Health Coverage (UHC)? Ans: All people receiving needed quality health services without financial hardship.
Question No.47: What is the name of Pakistan’s health insurance program? Ans: Sehat Sahulat Program (Sehat Card).
Question No.48: Which disease classification system does WHO publish? Ans: ICD, the International Classification of Diseases (ICD-11 has been in effect since 2022).
Question No.49: What is the purpose of a death certificate cause-of-death sequence? Ans: To record the underlying cause of death as the condition that started the chain of events.
Question No.50: What are the four core principles of medical ethics? Ans: Autonomy, beneficence, non-maleficence and justice.
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ڈیلی فری ٹیسٹ سیریز اور آن لائن باقاعدہ تیاری سیشن کا حصہ بننے کے لیے ابھی ہمارا واٹس ایپ چینل جوائن کریں اور گھر بیٹھے امتحانات میں کامیابی حاصل کریں!
PART B – BIOSTATISTICS & HOSPITAL ADMINISTRATION (Q51–100)
Question No.51: Which measure of central tendency is best for skewed data? Ans: The median.
Question No.52: What percentage of values fall within ±2 SD in a normal distribution? Ans: About 95% (68% within ±1 SD and 99.7% within ±3 SD).
Question No.53: What is a Type I error? Ans: Rejecting a true null hypothesis (false positive, α).
Question No.54: What is a Type II error? Ans: Failing to reject a false null hypothesis (false negative, β).
Question No.55: What is statistical power? Ans: 1 − β, usually set at 80%.
Question No.56: Which test compares proportions or categorical data? Ans: Chi-square test.
Question No.57: Which test compares the means of two groups? Ans: Student’s t-test.
Question No.58: Which test compares the means of more than two groups? Ans: ANOVA.
Question No.59: What does the Pearson correlation coefficient measure? Ans: The strength of linear association between two continuous variables (range −1 to +1).
Question No.60: What does a p-value below 0.05 mean? Ans: The result is statistically significant at the 5% level.
Question No.61: What is the Bed Occupancy Rate? Ans: (Total inpatient days ÷ (beds × days in period)) × 100.
Question No.62: What is the ideal bed occupancy rate? Ans: About 80–85%.
Question No.63: What is the Average Length of Stay (ALOS)? Ans: Total inpatient days ÷ total discharges (including deaths).
Question No.64: What is the Bed Turnover Rate? Ans: Number of discharges (including deaths) ÷ number of beds over a period.
Question No.65: What is the Net Death Rate? Ans: Hospital death rate excluding deaths within 48 hours of admission.
Question No.66: Who gave the 14 principles of management? Ans: Henri Fayol.
Question No.67: What does POSDCORB stand for? Ans: Planning, Organizing, Staffing, Directing, Coordinating, Reporting and Budgeting (Luther Gulick).
Question No.68: Who is the father of scientific management? Ans: F.W. Taylor.
Question No.69: What does Herzberg’s two-factor theory divide work factors into? Ans: Hygiene factors and motivators.
Question No.70: Which theory proposes Theory X and Theory Y? Ans: Douglas McGregor’s.
Question No.71: What is a SWOT analysis? Ans: An analysis of Strengths, Weaknesses, Opportunities and Threats.
Question No.72: What is span of control? Ans: The number of subordinates a manager can effectively supervise.
Question No.73: Who developed the Balanced Scorecard? Ans: Kaplan and Norton.
Question No.74: What is HMIS? Ans: A Health/Hospital Management Information System for collecting and using service data.
Question No.75: What platform is widely used for district health information? Ans: DHIS2 (District Health Information System).
Question No.76: What is triage? Ans: Sorting patients by urgency of treatment need.
Question No.77: What does the red category mean in START mass-casualty triage? Ans: Immediate, life-threatening but salvageable.
Question No.78: What does “Code Blue” usually indicate in hospitals? Ans: Cardiac or respiratory arrest.
Question No.79: What does “Code Red” usually indicate in hospitals? Ans: Fire.
Question No.80: What does RACE stand for in fire response? Ans: Rescue, Alarm, Contain, Extinguish.
Question No.81: What does PASS stand for in using a fire extinguisher? Ans: Pull, Aim, Squeeze, Sweep.
Question No.82: Which extinguisher is suitable for electrical fires? Ans: CO₂ (or dry chemical powder).
Question No.83: What is the colour code for a medical oxygen cylinder in Pakistan (ISO)? Ans: Black body with a white shoulder.
Question No.84: What is the cylinder colour for nitrous oxide? Ans: Blue.
Question No.85: What is the storage temperature of whole blood and packed red cells? Ans: 2–6°C.
Question No.86: What is the storage temperature of platelets? Ans: 20–24°C with continuous agitation.
Question No.87: What is the storage temperature of Fresh Frozen Plasma? Ans: −18°C or colder (preferably ≤ −25°C).
Question No.88: What is the recommended number of air changes per hour in an operation theatre? Ans: At least 20 ACH under positive pressure.
Question No.89: What is the recommended temperature and humidity in an OT? Ans: About 20–24°C and 30–60% relative humidity.
Question No.90: What is CSSD? Ans: Central Sterile Services Department, which handles cleaning, sterilization and supply of instruments.
Question No.91: What is credentialing? Ans: Verifying a practitioner’s qualifications, licensure and experience.
Question No.92: What is privileging? Ans: Authorizing specific clinical procedures a credentialed practitioner may perform.
Question No.93: What is the purpose of Morbidity & Mortality (M&M) meetings? Ans: Non-punitive peer review of adverse outcomes to improve care.
Question No.94: What are the five rights of medication administration? Ans: Right patient, right drug, right dose, right route and right time.
Question No.95: What are LASA drugs? Ans: Look-Alike Sound-Alike drugs, a major source of medication errors.
Question No.96: What are high-alert medications? Ans: Drugs with a high risk of serious harm if misused, such as insulin, concentrated KCl, heparin and opioids.
Question No.97: What is the WHO AWaRe classification? Ans: A grouping of antibiotics into Access, Watch and Reserve groups for stewardship.
Question No.98: What is antimicrobial stewardship? Ans: A coordinated program to promote appropriate antimicrobial use and limit resistance.
Question No.99: What is the Glasgow Coma Scale range? Ans: 3 to 15.
Question No.100: Which scale assesses pressure ulcer risk? Ans: The Braden Scale (the Morse Fall Scale assesses fall risk).
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ڈیلی فری ٹیسٹ سیریز اور آن لائن باقاعدہ تیاری سیشن کا حصہ بننے کے لیے ابھی ہمارا واٹس ایپ چینل جوائن کریں اور گھر بیٹھے امتحانات میں کامیابی حاصل کریں!
PART C – QUALITY ASSURANCE & PATIENT SAFETY (Q101–145)
Question No.101: What is Donabedian’s model of quality? Ans: Structure, Process and Outcome.
Question No.102: What are the IOM’s six domains of quality (STEEEP)? Ans: Safe, Timely, Effective, Efficient, Equitable and Patient-centred.
Question No.103: Which IOM report (1999) highlighted medical errors? Ans: “To Err is Human.”
Question No.104: What is the PDCA cycle? Ans: Plan–Do–Check–Act, the Deming/Shewhart cycle for continuous improvement.
Question No.105: What is Juran’s trilogy? Ans: Quality planning, quality control and quality improvement.
Question No.106: Who introduced the concept of “Zero Defects”? Ans: Philip Crosby.
Question No.107: What does Six Sigma aim for? Ans: 3.4 defects per million opportunities.
Question No.108: What is the DMAIC cycle in Six Sigma? Ans: Define, Measure, Analyze, Improve and Control.
Question No.109: What is Kaizen? Ans: Small, continuous incremental improvement (a Japanese philosophy).
Question No.110: What does Lean management focus on? Ans: Eliminating waste and non-value-added steps.
Question No.111: What is the Pareto principle? Ans: 80% of problems come from 20% of causes.
Question No.112: What is a fishbone diagram? Ans: A cause-and-effect diagram (Ishikawa) used to find root causes.
Question No.113: What is the “5 Whys” technique? Ans: Asking “why” repeatedly to reach the root cause.
Question No.114: What is the difference between RCA and FMEA? Ans: RCA is reactive (after an event); FMEA is proactive (before failure occurs).
Question No.115: What is the Risk Priority Number in FMEA? Ans: Severity × Occurrence × Detection.
Question No.116: What is benchmarking? Ans: Comparing performance with best practices or peers to improve.
Question No.117: What are SERVQUAL’s five dimensions? Ans: Tangibles, reliability, responsiveness, assurance and empathy.
Question No.118: What is clinical governance? Ans: A framework for organizations to be accountable for continuously improving quality and safeguarding standards (UK, 1998).
Question No.119: What are the steps of the clinical audit cycle? Ans: Set standard → measure practice → compare → implement change → re-audit.
Question No.120: What is the difference between clinical audit and research? Ans: Audit measures practice against existing standards; research generates new knowledge.
Question No.121: What is the difference between licensing and accreditation? Ans: Licensing is a mandatory government permission to operate; accreditation is voluntary external recognition of meeting standards.
Question No.122: What is JCI? Ans: Joint Commission International, an international hospital accreditation body.
Question No.123: Which ISO standard covers Quality Management Systems? Ans: ISO 9001:2015.
Question No.124: Which ISO standard applies to medical laboratories? Ans: ISO 15189.
Question No.125: Which ISO standards cover environmental management and occupational health & safety? Ans: ISO 14001 and ISO 45001.
Question No.126: What is tracer methodology? Ans: An inspection technique that follows a patient’s journey through the facility to assess care systems (JCI).
Question No.127: What is an adverse event? Ans: Unintended harm to a patient caused by healthcare rather than by the underlying disease.
Question No.128: What is a near miss? Ans: An error caught before it reached the patient.
Question No.129: What is a sentinel event? Ans: An unexpected occurrence resulting in death or serious physical or psychological harm.
Question No.130: What are “never events”? Ans: Serious, preventable incidents that should never occur, such as wrong-site surgery or a retained surgical item.
Question No.131: Within what time does JCI expect an RCA after a sentinel event? Ans: Within 45 business days.
Question No.132: Who gave the Swiss Cheese Model of errors? Ans: James Reason.
Question No.133: What is a “Just Culture”? Ans: A culture that balances non-punitive learning from errors with accountability for reckless behaviour.
Question No.134: What should an incident reporting system be? Ans: Voluntary, confidential, non-punitive and focused on system learning.
Question No.135: What are the six JCI International Patient Safety Goals? Ans: Identify patients correctly, improve communication, high-alert medication safety, safe surgery, reduce HAIs, and reduce harm from falls.
Question No.136: How many identifiers are required for patient identification? Ans: At least two, such as name and MR number or date of birth (never the room or bed number).
Question No.137: What is SBAR? Ans: Situation, Background, Assessment, Recommendation, a structured communication tool.
Question No.138: What are the three phases of the WHO Surgical Safety Checklist? Ans: Sign In, Time Out and Sign Out.
Question No.139: When was the WHO Surgical Safety Checklist launched? Ans: 2008 (“Safe Surgery Saves Lives”).
Question No.140: When is World Patient Safety Day observed? Ans: 17 September.
Question No.141: What is open disclosure? Ans: Honest communication with patients and families after an adverse event.
Question No.142: What are the four elements of medical negligence? Ans: Duty of care, breach of duty, causation and damage.
Question No.143: Which test judges the standard of care in negligence? Ans: The Bolam test (practice accepted by a responsible body of medical opinion).
Question No.144: What are the essential elements of valid informed consent? Ans: Capacity, adequate disclosure, understanding and voluntariness.
Question No.145: What is the NEWS score? Ans: National Early Warning Score, which detects clinical deterioration from vital signs.
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ڈیلی فری ٹیسٹ سیریز اور آن لائن باقاعدہ تیاری سیشن کا حصہ بننے کے لیے ابھی ہمارا واٹس ایپ چینل جوائن کریں اور گھر بیٹھے امتحانات میں کامیابی حاصل کریں!
PART D – INFECTION CONTROL, MSDS & WASTE MANAGEMENT (Q146–180)
Question No.146: What are standard precautions? Ans: Infection control practices applied to all patients regardless of diagnosis: hand hygiene, PPE, safe injection practices and so on.
Question No.147: What are WHO’s “5 Moments for Hand Hygiene”? Ans: Before touching a patient, before an aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings.
Question No.148: What is the recommended duration of an alcohol hand rub and a hand wash? Ans: 20–30 seconds for hand rub and 40–60 seconds for hand wash.
Question No.149: What is the effective alcohol concentration in hand rubs? Ans: 60–80% (commonly 70%).
Question No.150: What is the gold standard for monitoring hand hygiene compliance? Ans: Direct observation audit.
Question No.151: What is a healthcare-associated infection (HAI)? Ans: An infection acquired in a healthcare facility that was not present or incubating at admission (usually appearing after 48 hours).
Question No.152: What are the four major device- and procedure-associated HAIs? Ans: CAUTI, CLABSI, VAP and SSI.
Question No.153: What is the Spaulding classification? Ans: Critical, semi-critical and non-critical items, based on infection risk.
Question No.154: What processing do critical items need? Ans: Sterilization (they enter sterile tissue, e.g. surgical instruments).
Question No.155: What processing do semi-critical items need? Ans: At least high-level disinfection (they contact mucous membranes, e.g. endoscopes).
Question No.156: What are the standard autoclave parameters? Ans: 121°C at 15 psi for 15–20 minutes (or 134°C for 3–4 minutes).
Question No.157: What are the hot air oven parameters? Ans: 160°C for 2 hours.
Question No.158: Which biological indicator is used for steam sterilization? Ans: Geobacillus stearothermophilus spores.
Question No.159: What is the Bowie-Dick test? Ans: A daily test of air removal in pre-vacuum autoclaves.
Question No.161: What is a common high-level disinfectant? Ans: 2% glutaraldehyde.
Question No.162: What hypochlorite concentration is used for blood spills? Ans: 0.5–1% sodium hypochlorite.
Question No.163: What PPE is required for airborne precautions? Ans: An N95 respirator and a negative-pressure room (≥12 ACH).
Question No.164: Which precautions are used for influenza? Ans: Droplet precautions (surgical mask, distance of at least 1 metre).
Question No.165: Which precautions are used for MRSA? Ans: Contact precautions (gown and gloves).
Question No.166: What is the CDC sequence for donning PPE? Ans: Gown → mask/respirator → goggles/face shield → gloves.
Question No.167: What is the CDC sequence for doffing PPE? Ans: Gloves → goggles/face shield → gown → mask (with hand hygiene after removal).
Question No.168: What are the transmission risks after a needle-stick injury? Ans: About 30% for HBV, 1.8% for HCV and 0.3% for HIV.
Question No.169: When should HIV post-exposure prophylaxis be started? Ans: Ideally within 2 hours, and no later than 72 hours.
Question No.170: What is MSDS (as a chemical safety document)? Ans: A Material Safety Data Sheet (now SDS) giving hazard, handling, storage, PPE and first-aid information for chemicals, including disinfectants.
Question No.171: How many sections does a GHS-format SDS contain? Ans: 16 sections.
Question No.172: What proportion of healthcare waste is hazardous (WHO)? Ans: About 15%; the remaining 85% is general, non-hazardous waste.
Question No.173: Which law gives the federal Hospital Waste Management Rules in Pakistan? Ans: The Pakistan Environmental Protection Act 1997 (Hospital Waste Management Rules 2005).
Question No.174: Which rules govern hospital waste in Punjab? Ans: The Punjab Hospital Waste Management Rules 2014.
Question No.175: What is the WHO colour code for infectious waste? Ans: Yellow bags or containers (general waste goes in black).
Question No.176: How should sharps be disposed of? Ans: In puncture-proof, leak-proof sharps containers, sealed when ¾ full, with no needle recapping.
Question No.177: What are the recommended incinerator temperatures? Ans: 850°C or above in the primary chamber and about 1,100°C in the secondary chamber.
Question No.178: What is the first and most important step in waste management? Ans: Segregation at the point of generation.
Question No.179: Which international convention aims to phase out mercury, including in health devices? Ans: The Minamata Convention (2013).
Question No.180: Who in a hospital is responsible for waste management under the rules? Ans: The head of the institution, assisted by a Waste Management Officer and Waste Management Team.
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ڈیلی فری ٹیسٹ سیریز اور آن لائن باقاعدہ تیاری سیشن کا حصہ بننے کے لیے ابھی ہمارا واٹس ایپ چینل جوائن کریں اور گھر بیٹھے امتحانات میں کامیابی حاصل کریں!
PART E – HEALTHCARE LAWS, INSPECTIONS, COMPLAINTS & M&E (Q181–200)
Question No.181: What is PM&DC? Ans: The Pakistan Medical and Dental Council, the regulator for registration and licensing of doctors and dentists (restored under the PMDC Act 2023).
Question No.182: Under which law was the Punjab Healthcare Commission established? Ans: The Punjab Healthcare Commission Act 2010.
Question No.183: What are the main functions of the Punjab Healthcare Commission? Ans: Registration and licensing of healthcare establishments, enforcing standards, handling complaints, and action against quackery.
Question No.184: What does MSDS mean in the Punjab Healthcare Commission’s context? Ans: Minimum Service Delivery Standards, which every healthcare establishment must meet for licensing.
Question No.185: Under which act was DRAP established? Ans: The Drug Regulatory Authority of Pakistan Act 2012.
Question No.186: What are the common types of inspections in healthcare regulation? Ans: Announced, unannounced, follow-up and complaint-based inspections.
Question No.187: What is a non-conformity? Ans: Failure to meet a specified standard or requirement.
Question No.188: What is the difference between a major and a minor non-conformity? Ans: A major one is a systemic or serious risk to patient safety; a minor one is an isolated lapse with limited impact.
Question No.189: What is CAPA? Ans: Corrective and Preventive Action.
Question No.190: What is the difference between correction, corrective action and preventive action? Ans: Correction fixes the immediate problem, corrective action removes the root cause to prevent recurrence, and preventive action eliminates potential causes before they occur.
Question No.191: What is the usual sequence of regulatory action for non-compliance? Ans: Inspection report → show-cause notice → hearing → corrective timeline → fine, suspension or sealing if non-compliance persists.
Question No.192: What is the key principle in handling a non-compliance case? Ans: Due process: evidence-based findings, the right of hearing and a written, reasoned decision.
Question No.193: What are the steps in complaint redressal? Ans: Receive and register → acknowledge → investigate → resolve and decide → communicate to complainant → close and analyse trends.
Question No.194: What is the purpose of analysing complaint trends? Ans: To identify systemic problems and drive quality improvement.
Question No.195: What is the difference between monitoring and evaluation? Ans: Monitoring is continuous tracking of progress; evaluation is a periodic assessment of relevance, effectiveness, efficiency, impact and sustainability.
Question No.196: What is the results chain in M&E? Ans: Inputs → Activities/Processes → Outputs → Outcomes → Impact.
Question No.197: What does a SMART indicator mean? Ans: Specific, Measurable, Achievable, Relevant and Time-bound.
Question No.198: What is a Logical Framework (Logframe)? Ans: A matrix linking goals, objectives, outputs and activities with indicators, means of verification and assumptions.
Question No.199: What is the difference between formative and summative evaluation? Ans: Formative evaluation is done during implementation to improve a program; summative evaluation is done at the end to judge overall results.
Question No.200: What is gap analysis in quality assessment? Ans: Comparing current performance with required standards to identify deficiencies and plan corrective actions.
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ڈیلی فری ٹیسٹ سیریز اور آن لائن باقاعدہ تیاری سیشن کا حصہ بننے کے لیے ابھی ہمارا واٹس ایپ چینل جوائن کریں اور گھر بیٹھے امتحانات میں کامیابی حاصل کریں!
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