Endemic fluorosis is prevalent in which of the following states of India?
a. Andhra Pradesh
b. Tamil Nadu
c. Punjab
d. West Bengal

Appeared in: MNS 2024

Explanation

Endemic fluorosis is a major public health problem in India caused by consuming water with high fluoride levels.
The condition is widespread across numerous states in the country.
Sources confirm that Andhra Pradesh, Punjab, and Tamil Nadu are states with endemic fluorosis.
West Bengal is also a recognized endemic state, making the option that includes all four states the correct answer.

Option A: This option is incorrect because it omits Punjab (C), which is explicitly mentioned in authoritative texts as a state endemic for fluorosis.
Option B: This option is incorrect because it excludes Tamil Nadu (B), another state clearly identified in health literature as being affected by endemic fluorosis.
Option D: This option is incorrect as it leaves out Andhra Pradesh (A), a state well-documented for high prevalence of fluorosis, with specific districts like Nalgonda being severely affected.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Geographical distribution of endemic fluorosis in India as background academic context rather than a clinical decision trigger.
Nurses play a vital role in public health surveillance, screening for early signs of fluorosis (e.g., dental mottling), and educating communities about safe drinking water practices.
Understanding the geographical distribution of fluorosis helps healthcare professionals maintain a high index of suspicion when patients from these areas present with joint pain, bone deformities, or dental issues.
What if? If a child from an endemic area presents with genu valgum (knock-knees) and a diet poor in calcium, the nurse should have a high suspicion of skeletal fluorosis and facilitate a referral for orthopedic and nutritional evaluation.

How to Approach the Question

First, identify the core concept of the question, which is the geographical prevalence of 'Endemic fluorosis' in India.
Recall or use knowledge of major public health issues in India to consider which states are commonly affected.
Systematically evaluate each state listed in the sub-options (a, b, c, d).
Based on the confirmation that Andhra Pradesh, Punjab, and Tamil Nadu are all endemic states, look for the option that includes all three.
The only option that includes A, B, and C is 'A, B, C and D'. By elimination of other options, this becomes the most plausible answer, assuming the question is well-posed and includes all relevant states.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 181-183

E6 Comprehensive Textbook of Community Health NursingShyamala D part 1 (pp 26-389 of 389) p. 210-212

Practise the full MNS 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.