UPSC-CMS 2018 - Community Medicine Practice Questions

Q: Caisson’s disease is usually seen in which group of workers?

Construction workers under sea level. ***Construction workers under sea level*** - **Caisson's disease**, also known as **decompression sickness** or **the bends**, occurs when individuals experience a rapid decrease in surrounding pressure. - Workers such as **divers, underwater construction workers, and tunnel builders** often work in high-pressure environments and are at risk if they ascend too quickly. *Workers in manufacture of gas* - While gas manufacturing can involve exposure to various chemicals and potential respiratory hazards, it does not typically involve the significant changes in **ambient pressure** that cause Caisson's disease. - This profession is not associated with the **rapid decompression** necessary for nitrogen bubbles to form in tissues. *Workers in radiation units* - Workers in radiation units are at risk of conditions related to **ionizing radiation exposure**, such as cancer or radiation sickness. - Their work environment does not involve changes in **pressure** that lead to Caisson's disease. *Cotton field agricultural workers* - Agricultural workers in cotton fields may suffer from respiratory conditions like **byssinosis** ("brown lung") due to cotton dust exposure. - Their work environment does not involve **hyperbaric conditions** or rapid decompression, which are prerequisites for Caisson's disease.

Q: These toxic effects like abdominal colic, obstinate constipation, loss of appetite, anaemia, stippling of red cells and blue line on gums are due to exposure to:

Lead. ***Lead*** - The constellation of symptoms including **abdominal colic**, **obstinate constipation**, **loss of appetite**, **anemia**, **stippling of red cells**, and a **blue line on the gums (Burton's line)** are classic manifestations of **chronic lead poisoning**. - Lead interferes with multiple organ systems, notably the **gastrointestinal**, **hematologic**, and **nervous systems**, causing these specific toxic effects. *Carbon monoxide* - **Carbon monoxide poisoning** primarily affects oxygen transport, leading to symptoms like headache, dizziness, nausea, and in severe cases, coma and death. - It does not cause abdominal colic, obstinate constipation, stippling of red cells, or a blue line on the gums. *Radiation* - **Radiation exposure** can lead to acute radiation syndrome with symptoms like nausea, vomiting, fatigue, hair loss, and damage to rapidly dividing cells, or long-term effects like cancer. - The symptoms described in the question are not characteristic of radiation sickness or exposure. *Asbestos* - **Asbestos exposure** is primarily associated with respiratory illnesses such as **asbestosis**, **mesothelioma**, and **lung cancer**, which develop many years after exposure. - It does not cause acute abdominal symptoms, anemia with red cell stippling, or a blue line on the gums.

Q: Which of the following is NOT a mass approach in health communication?

Role play. ***Role play*** - **Role play** is an **interpersonal** or **group communication** technique where individuals act out scenarios to practice skills or understand different perspectives. - It is not a **mass media approach** as it involves direct, interactive participation with a limited number of people. *Posters* - **Posters** are visual aids designed to convey information to a large, undifferentiated audience in public spaces. - They are a classic example of **mass communication** due to their wide reach and static display. *Health exhibition* - A **health exhibition** is a public event designed to educate a large number of people about health topics through various displays, stalls, and interactive presentations. - Such exhibitions utilize a range of media to reach a broad audience, making them a **mass approach**. *Folk methods* - **Folk methods** in health communication include traditional storytelling, skits, and songs performed by local artists or groups in public settings. - These methods are used to disseminate health messages to a community or large gathering, leveraging cultural resonance for **mass appeal**.

Q: Which of the following are non-modifiable risk factors for hypertension? 1. Age 2. Sex 3. Genetic factors Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Age** is a significant non-modifiable risk factor for hypertension; blood pressure tends to increase with advancing age due to arterial stiffness and other physiological changes. - While lifestyle and environmental factors play a role, **genetic predisposition** (hereditary factors) is a well-established non-modifiable risk factor that influences an individual's susceptibility to hypertension. - **Sex** is also considered a non-modifiable risk factor, as hormonal differences and physiological variations between biological sexes influence the prevalence and progression of hypertension across different life stages. *1 only* - This option is incomplete as it excludes other well-recognized non-modifiable risk factors like **sex** and **genetic factors**. - While **age** is a crucial non-modifiable risk factor, focusing solely on it would overlook a comprehensive understanding of inherent risks. *1 and 2 only* - This option incorrectly omits **genetic factors**, which are fundamental non-modifiable determinants of hypertension risk. - Although **age** and **sex** are valid non-modifiable factors, the absence of **genetic predisposition** makes this option incomplete. *2 and 3 only* - This option incorrectly excludes **age**, which is one of the most prominent non-modifiable risk factors for hypertension, as blood pressure generally rises with age. - Omitting **age** from the list of non-modifiable factors provides an incomplete understanding of inherent hypertension risks.

Q: What is the correct daily dose of Iron and Folic acid to be prescribed to a child aged 12 years?

60 mg elemental Iron and 300 mcg folic acid. ***60 mg elemental Iron and 300 mcg folic acid*** - This is the **standard daily prophylactic dose** recommended for children aged 10-19 years (adolescents) in India as per **WIFS (Weekly Iron and Folic Acid Supplementation) program** when given daily. - Aligns with **ICMR and National Iron+ Initiative** guidelines for daily supplementation in adolescents. - This dose provides adequate iron for growth requirements and prevention of **nutritional anemia** in this age group. *20 mg elemental Iron and 100 mcg folic acid* - This dose is **too low** for a 12-year-old child and does not meet the iron requirements for adolescents. - This might be appropriate for younger children (6-59 months) but is **inadequate for adolescent growth and development**. - Would not effectively prevent iron deficiency anemia in this age group. *100 mg elemental Iron and 500 mcg folic acid* - This is the dose recommended for **weekly prophylactic supplementation** under the WIFS program, not for daily use. - When used daily, this dose may be used for **treatment of established iron deficiency anemia** rather than routine prophylaxis. - Daily use at this dose may cause **gastrointestinal side effects** like nausea and constipation. *30 mg elemental Iron and 250 mcg folic acid* - This dose is **intermediate but not standard** as per Indian guidelines for this age group. - Does not align with recommended protocols for adolescent supplementation. - Provides suboptimal iron for the growth spurt and increased requirements in 12-year-olds.

Q: As per biomedical waste management rule 2016 the metallic body implants should be discarded in which of the following?

Separate collection system. ***Separate collection system*** - Metallic body implants, due to their nature and potential for **recycling or specific disposal methods**, are to be segregated into a **separate collection system** as per BMW Rule 2016. - This ensures they do not contaminate other biomedical waste streams and can be handled appropriately, often involving **recovery of precious metals**. *Red colored non-chlorinated plastic bag* - This category is typically for **reusable contaminated waste** such as tubing, catheters, IV sets, and urine bags, which are often plastic. - Metallic implants are not typically suitable for disposal in red bags because they are not meant for incineration or autoclaving in the same manner as these plastic items. *Yellow colored non-chlorinated plastic bag* - Yellow bags are used for **human anatomical waste**, animal anatomical waste, soiled waste, expired or discarded medicines, and **chemical waste**. - Metallic implants do not fall into any of these categories and require a different disposal method due to their material composition and potential for recycling. *Card board box with blue colored marking* - Blue or white translucent boxes/containers are designated for **sharps**, including needles, syringes with fixed needles, and blades, as well as broken or contaminated glass. - While metallic, body implants are not considered "sharps" in the same context, nor are they typically discarded in cardboard, which is unsuitable for their weight and specific disposal requirements.

Q: Which of the following is NOT a quantitative method in the management of health services?

Management by objectives. ***Management by objectives*** - **Management by objectives (MBO)** is a strategic management model that aims to improve organizational performance by clearly defining objectives that are agreed upon by both management and employees. - While MBO involves setting **quantifiable goals** and measurable outcomes, the methodology itself is primarily a **qualitative management philosophy** focused on communication, participation, integration, and alignment rather than mathematical modeling or statistical analysis. - Unlike true quantitative methods, MBO does not employ **mathematical algorithms, computational techniques, or statistical modeling** for decision-making—making it the correct answer to this "NOT quantitative" question. *System analysis* - **System analysis** is a quantitative method used to study and optimize complex systems by breaking them down into components to understand their interactions and behavior. - It involves **mathematical modeling, simulation, operations research, and data analysis** to identify bottlenecks, improve efficiency, and make data-driven decisions. *Network analysis* - **Network analysis** is a quantitative technique using mathematical algorithms to model and analyze relationships and flows within a system. - Applications include **project management (PERT/CPM)**, critical path method, resource allocation using computational techniques, and optimization algorithms. *Planning programming budgeting system* - **Planning Programming Budgeting System (PPBS)** is a comprehensive, quantitative approach to government planning and budgeting that links policy planning to resource allocation through numerical analysis. - It involves setting long-term goals, analyzing alternative programs using **cost-effectiveness analysis, benefit-cost ratios**, and allocating resources based on quantitative economic evaluation.

Q: Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Maternal mortality. ***Maternal mortality*** - **Manual Vacuum Aspiration (MVA)** is a safe and effective method for managing **incomplete abortion** and **early pregnancy loss**, which are significant causes of **maternal mortality**, especially when performed in primary healthcare settings. - By providing timely and accessible care for these complications, MVA helps prevent severe complications like hemorrhage and sepsis that can lead to a mother's death. *Preterm mortality* - Preterm mortality is primarily related to **preterm birth** and its associated complications, such as respiratory distress syndrome and infection. - MVA is a procedure for managing early pregnancy loss or incomplete abortion and does not directly impact the incidence or outcomes of preterm births. *Neonatal mortality* - Neonatal mortality refers to deaths of infants within the first 28 days of life, often due to issues like **birth asphyxia**, **prematurity**, and **neonatal infections**. - MVA addresses complications of pregnancy for the mother and does not directly relate to the common causes of death in newborns. *Infant mortality* - Infant mortality encompasses deaths from birth up to one year of age, including causes such as **sudden infant death syndrome (SIDS)**, congenital anomalies, and infections occurring after the neonatal period. - While improved maternal health can indirectly benefit infant survival, MVA directly tackles maternal health crises rather than primary causes of infant death.

Q: The agreement (yes/no) between two observers is statistically measured by:

Kappa coefficient. **Kappa coefficient** - The **kappa coefficient** measures the **inter-rater agreement** for qualitative items, such as a "yes/no" decision, beyond what would be expected by chance. - It takes into account the observed agreement and the agreement expected by chance, providing a more robust measure of agreement than simple percentage agreement. *Correlation coefficient* - The **correlation coefficient** measures the **strength and direction of a linear relationship between two quantitative variables**, not the agreement between two observers on a categorical outcome. - It is used for continuous data and indicates how closely data points fit a linear regression line. *Sensitivity* - **Sensitivity** is a measure of a test's ability to correctly identify individuals who **have a disease (true positive rate)**. - It is not used to assess the agreement between two observers but rather the performance of a diagnostic test against a gold standard. *Specificity* - **Specificity** is a measure of a test's ability to correctly identify individuals who **do not have a disease (true negative rate)**. - Like sensitivity, it evaluates the performance of a diagnostic test and not the consistency of observations between two different raters.

Q: How many postnatal visits should be made by the ANM to the house of a low birth weight baby?

4. ***4*** - For a **low birth weight (LBW) baby**, as per traditional guidelines, an **Auxiliary Nurse Midwife (ANM)** makes postnatal home visits on **day 1, day 3, day 7, and day 14** after birth = **4 visits**. - This represents the **minimum essential visits** during the critical first two weeks for monitoring growth, feeding, and identifying complications. - **Note**: Current HBNC guidelines recommend at least 6 visits (adding day 28 and 42) for all newborns, with more intensive follow-up for LBW babies. *8* - Eight visits are **not the standard recommendation** for a low birth weight baby's postnatal care by an ANM. - While more frequent follow-ups may be clinically indicated in some complex cases, it is not the general guideline for all LBW babies. *2* - Two postnatal visits are **insufficient** for proper monitoring of a **low birth weight baby**, who is at higher risk for health issues. - This number of visits would miss critical periods for identifying complications or providing essential care. *6* - Six postnatal visits represent the **current HBNC (Home Based Newborn Care) guideline** for all newborns (days 1, 3, 7, 14, 28, 42). - However, the answer key for this UPSC-CMS 2018 question indicates **4 visits** as the expected answer, likely reflecting guidelines at that time.

Question 1

Caisson’s disease is usually seen in which group of workers?

Accepted Answer

Construction workers under sea level

Answer

Workers in manufacture of gas

Answer

Workers in radiation units

Answer

Cotton field agricultural workers

Question 2

These toxic effects like abdominal colic, obstinate constipation, loss of appetite, anaemia, stippling of red cells and blue line on gums are due to exposure to:

Accepted Answer

Lead

Answer

Carbon monoxide

Answer

Radiation

Answer

Asbestos

Question 3

Which of the following is NOT a mass approach in health communication?

Accepted Answer

Role play

Answer

Posters

Answer

Health exhibition

Answer

Folk methods

Question 4

Which of the following are non-modifiable risk factors for hypertension?

1. Age
2. Sex
3. Genetic factors

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 only

Answer

1 and 2 only

Answer

2 and 3 only

Question 5

What is the correct daily dose of Iron and Folic acid to be prescribed to a child aged 12 years?

Accepted Answer

60 mg elemental Iron and 300 mcg folic acid

Answer

30 mg elemental Iron and 250 mcg folic acid

Answer

20 mg elemental Iron and 100 mcg folic acid

Answer

100 mg elemental Iron and 500 mcg folic acid

Question 6

As per biomedical waste management rule 2016 the metallic body implants should be discarded in which of the following?

Accepted Answer

Separate collection system

Answer

Red colored non-chlorinated plastic bag

Answer

Yellow colored non-chlorinated plastic bag

Answer

Card board box with blue colored marking

Question 7

Which of the following is NOT a quantitative method in the management of health services?

Accepted Answer

Management by objectives

Answer

System analysis

Answer

Network analysis

Answer

Planning programming budgeting system

Question 8

Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Accepted Answer

Maternal mortality

Answer

Preterm mortality

Answer

Neonatal mortality

Answer

Infant mortality

Question 9

The agreement (yes/no) between two observers is statistically measured by:

Accepted Answer

Kappa coefficient

Answer

Correlation coefficient

Answer

Sensitivity

Answer

Specificity

Question 10

How many postnatal visits should be made by the ANM to the house of a low birth weight baby?

Accepted Answer

4

Answer

8

Answer

2

Answer

6

UPSC-CMS 2018 — Community Medicine