UPSC-CMS 2020 - Community Medicine Practice Questions

Q: Which one of the following is NOT a contagious disease?

Malaria. ***Malaria*** - Malaria is caused by **Plasmodium parasites** transmitted through the bite of infected Anopheles mosquitoes. It is not spread directly from person to person. - Transmission requires a **vector** (mosquito), making it a non-contagious infectious disease. *Trachoma* - Trachoma is a contagious bacterial infection caused by **Chlamydia trachomatis**, spread through direct contact with eye and nose discharge of an infected person. - It can also be transmitted via **fomites** like contaminated towels or clothing, or through eye-seeking flies. *Leprosy* - Leprosy, caused by **Mycobacterium leprae**, is a chronic infectious disease that is considered contagious, although with low infectivity. - It is primarily transmitted through **nasal droplets** during close and prolonged contact with an untreated infected person. *Scabies* - Scabies is a contagious skin infestation caused by the **mite Sarcoptes scabiei**, which burrows into the outer layer of the skin. - It is easily spread through **direct, prolonged skin-to-skin contact** with an infected person.

Q: Pentavalent vaccine provides protection against which of the following diseases?

Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib. ***Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib*** - The **Pentavalent vaccine** is a combination vaccine that provides protection against five common childhood diseases. - These five diseases are **Diphtheria**, **Pertussis** (whooping cough), **Tetanus**, **Hepatitis B**, and infections caused by **Haemophilus influenzae type b (Hib)**. *Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B* - While it includes **Diphtheria**, **Pertussis**, and **Hepatitis B**, this option incorrectly lists **Tuberculosis** and **Measles** as components. - The vaccine for Tuberculosis is **BCG**, and Measles is part of the MMR vaccine, not the pentavalent vaccine. *Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella* - This option correctly identifies **Diphtheria**, **Pertussis**, **Tetanus**, and **Hepatitis B** but incorrectly includes **Rubella**. - **Rubella** is typically part of the **MMR vaccine**, not the pentavalent vaccine. *Diphtheria, Pertussis, Measles, Hepatitis B and Hib* - This option correctly includes **Diphtheria**, **Pertussis**, **Hepatitis B**, and **Hib**, but incorrectly lists **Measles**. - **Measles** is administered as part of the **MMR vaccine**, not as a component of the pentavalent vaccine.

Q: Consider the following data for a country: What shall be the dependency ratio of this country?

54.1 %. ***54.1 %*** - The **dependency ratio** measures the proportion of dependents (children 0-14 and elderly 65+) to the working-age population (15-64). - Calculation: ((391,558,367 + 71,943,390) / 856,076,200) × 100 = (463,501,757 / 856,076,200) × 100 = **54.14%**. *42.4 %* - This value is significantly **lower** than the calculated dependency ratio of 54.1%. - Would indicate a much smaller **dependent population** relative to the working-age group. *66.2 %* - This percentage is **higher** than the mathematically correct dependency ratio calculation. - Would suggest a larger proportion of **dependents** than actually exists in the given data. *78.6 %* - This value is significantly **overestimated** compared to the calculated dependency ratio. - Such a high ratio would indicate an unrealistic proportion of **non-working population** to working-age adults.

Q: Visual inspection based screening test with 5 % acetic acid is used for the screening of which one of the following cancers?

Cervix cancer. ***Cervix cancer*** - Visual inspection with **acetic acid (VIA)** is a widely used, low-cost screening method for **cervical cancer**, particularly in low-resource settings. - Acetic acid causes abnormal (dysplastic or cancerous) cervical cells to turn **white (acetowhite lesion)**, making them visible to the naked eye. *Oral cancer* - Screening for **oral cancer** typically involves a visual and tactile examination of the oral cavity by a dentist or healthcare provider. - While acetic acid can highlight some oral lesions, it is **not a standard diagnostic or screening tool** for oral cancer like it is for cervical cancer. *Lung cancer* - Screening for **lung cancer** usually involves **low-dose computed tomography (LDCT)** for high-risk individuals. - There is **no role for acetic acid** in the screening or diagnosis of lung cancer. *Breast cancer* - Screening for **breast cancer** is primarily done through **mammography**, clinical breast exams, and sometimes MRI. - **Acetic acid** has **no application** in the detection or screening of breast cancer.

Q: Predictive accuracy of a screening test depends on the following EXCEPT:

Disease incidence. ***Disease incidence*** - **Disease incidence** refers to the rate at which new cases of a disease occur in a population over a specified period. While related to disease prevalence, it is not a direct factor in calculating the predictive accuracy of a screening test. - Predictive accuracy, specifically **positive predictive value (PPV)** and **negative predictive value (NPV)**, relies on the test's inherent properties (sensitivity and specificity) and the **prevalence** of the disease, not its incidence. *Specificity of screening test* - **Specificity** is crucial for predictive accuracy as it determines the probability that a test correctly identifies those *without* the disease. - A test with high specificity will have fewer **false positives**, which directly impacts the positive predictive value. *Disease prevalence* - **Disease prevalence** profoundly influences the predictive accuracy of a screening test. The **positive predictive value** increases with higher disease prevalence. - In populations with low disease prevalence, even highly sensitive and specific tests can yield a large number of **false positives**. *Sensitivity of screening test* - **Sensitivity** is a key determinant of predictive accuracy, as it measures the proportion of *true positives* correctly identified by the test. - A test with high sensitivity helps ensure that most individuals *with* the disease are detected, which affects both **positive and negative predictive values**.

Q: How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6 months of age after an episode of acute diarrhoea?

10 mg per day for 10–14 days. **10 mg per day for 10–14 days** - For infants less than 6 months of age, **WHO and UNICEF** recommend **10 mg of elemental zinc per day** for 10-14 days following an acute diarrheal episode. - This dosage helps to reduce the severity and duration of the current diarrheal episode and prevents future episodes for several months. *20 mg per day for 10–14 days* - This dosage is recommended for **children 6 months of age and older**, not for infants under 6 months. - Providing 20 mg elemental zinc to infants under 6 months could lead to **zinc toxicity** or other adverse effects. *6 mg per day for 7 days* - This recommendation is below the **standard therapeutic dose** for infants, which may not be sufficient to achieve the desired clinical benefit. - The duration of **7 days** is also shorter than the generally recommended 10-14 days. *5 mg per day for 7 days* - Similar to 6 mg, this dose is **insufficient** for effective treatment of acute diarrhea in infants. - The shortened duration of 7 days further reduces its potential therapeutic impact, increasing the risk of **recurrence or prolonged symptoms**.

Q: Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in which of the following infectious diseases? 1. Tuberculosis 2. Leprosy 3. Chronic empyema Select the correct answer using the code given below:

1 and 2 only. ***1 and 2 only*** - Under the **Employees' State Insurance (ESI) Central Rules, 1950**, extended sickness benefit is provided for specified long-term diseases requiring prolonged treatment. - The diseases covered include **Tuberculosis** and **Leprosy**, both of which require extended treatment periods and justify enhanced support. - **Chronic empyema is NOT included** in the list of diseases eligible for extended sickness benefit under the ESI Scheme. - Other diseases covered include mental illness and malignant diseases (cancer). *1, 2 and 3* - This option is incorrect because **chronic empyema** is not listed among the diseases eligible for extended sickness benefit under ESI regulations. - While empyema may require medical care, it does not qualify for the specific extended sickness benefit provision. *2 and 3 only* - This option is incorrect as it omits **Tuberculosis**, which is a major disease specifically listed for extended sickness benefit under the ESI Scheme. - It also incorrectly includes chronic empyema, which is not covered. *1 and 3 only* - This option is incorrect because it includes **chronic empyema**, which is not eligible for extended sickness benefit. - While Tuberculosis is correctly included, the combination is inaccurate per ESI regulations.

Question 1

Which one of the following is NOT a contagious disease?

Accepted Answer

Malaria

Answer

Trachoma

Answer

Leprosy

Answer

Scabies

Question 2

Pentavalent vaccine provides protection against which of the following diseases?

Accepted Answer

Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib

Answer

Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B

Answer

Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella

Answer

Diphtheria, Pertussis, Measles, Hepatitis B and Hib

Question 3

Consider the following data for a country: What shall be the dependency ratio of this country?

Accepted Answer

54.1 %

Answer

42.4 %

Answer

78.6 %

Answer

66.2 %

Question 4

Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

Accepted Answer

It can be administered till 15 days after the first dose of anti-rabies vaccine

Answer

It should be administered primarily into or around the wound sites

Answer

There is no scientific ground for performing a skin test prior to administering equine immunoglobulin

Answer

It should be administered only once as soon as possible after the initiation of post exposure prophylaxis

Question 5

Visual inspection based screening test with 5 % acetic acid is used for the screening of which one of the following cancers?

Accepted Answer

Cervix cancer

Answer

Oral cancer

Answer

Lung cancer

Answer

Breast cancer

Question 6

Predictive accuracy of a screening test depends on the following EXCEPT:

Accepted Answer

Disease incidence

Answer

Specificity of screening test

Answer

Disease prevalence

Answer

Sensitivity of screening test

Question 7

How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6 months of age after an episode of acute diarrhoea?

Accepted Answer

10 mg per day for 10–14 days

Answer

20 mg per day for 10–14 days

Answer

6 mg per day for 7 days

Answer

5 mg per day for 7 days

Question 8

Which one of the following statements regarding sequential administration of Inactivated Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

Accepted Answer

Intestinal mucosal immunity is lost due to IPV administration

Answer

The combined schedules of IPV and OPV appear to reduce or prevent Vaccine Associated Paralytic Polio (VAPP)

Answer

It will be cost effective in developing countries for Polio prevention

Answer

IPV and OPV together may optimize both the humoral and mucosal immunogenicity of Polio vaccine

Question 9

All of the following are global targets for WHO Global Action Plan (2013–2020) for Prevention and Control of NCDs, EXCEPT:

Accepted Answer

A 15% relative reduction in healthcare costs related to NCDs

Answer

A 30% relative reduction in mean population intake of salt/sodium

Answer

A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases

Answer

At least 10 % relative reduction in the harmful use of alcohol

Question 10

Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in which of the following infectious diseases?

1. Tuberculosis
2. Leprosy
3. Chronic empyema

Select the correct answer using the code given below:

Accepted Answer

1 and 2 only

Answer

1, 2 and 3

Answer

2 and 3 only

Answer

1 and 3 only

UPSC-CMS 2020 — Community Medicine