UPSC-CMS 2023 - Community Medicine Practice Questions

Q: Which one among the following types of ventilation, best fits the following description - "A system of ventilation in which fresh air is blown into the room by centrifugal fans so as to create a positive pressure, and displace the vitiated air" ?

Plenum ventilation. ***Plenum ventilation*** - **Plenum ventilation** involves blowing fresh air into a space using fans, creating a **positive pressure** that displaces stale air. - This method is effective for maintaining good air quality and preventing the infiltration of unconditioned air from outside. *Exhaust ventilation* - **Exhaust ventilation** involves drawing air out of a space, creating a negative pressure, which allows fresh air to enter naturally. - This method is often used to remove contaminated air from specific areas, like kitchens or bathrooms, rather than supplying fresh air to an entire room. *Balanced ventilation* - **Balanced ventilation** systems aim to supply and exhaust equal amounts of air, maintaining neutral pressure within the space. - While it uses fans for both supply and exhaust, it doesn't primarily aim to create a positive pressure and displace air as described. *Natural ventilation* - **Natural ventilation** relies on natural forces like wind pressure and thermal buoyancy to move air through a building. - It does not involve mechanical fans to blow air, nor does it typically create a controlled positive pressure to displace vitiated air.

Q: The 'Nalgonda Technique' developed by the National Environmental Engineering Research Institute (NEERI) was developed primarily for the removal of which one of the following from water ?

Fluoride. ***Fluoride*** - The **Nalgonda Technique** is a defluoridation method primarily used to remove excess **fluoride** from drinking water. - This technique utilizes the principles of chemical precipitation, adsorption, and ion exchange, using **alum** (aluminum sulfate), **lime**, and **bleaching powder** as coagulants. - Developed by NEERI to address endemic **fluorosis** in areas with high fluoride content in groundwater, particularly in regions like Nalgonda district in Telangana. *Chlorine* - Chlorine is commonly used as a **disinfectant** in water treatment to kill bacteria and viruses, not as a target for removal by the Nalgonda Technique. - Excess chlorine can be removed via activated carbon filtration or aeration, methods distinct from the Nalgonda process. *Iron* - Iron removal from water typically involves **aeration**, oxidation (e.g., with chlorine or potassium permanganate), followed by filtration. - While alum (a component of the Nalgonda Technique) can aid in iron precipitation, the Nalgonda Technique's primary design is not for iron removal. *Asbestos* - Asbestos fibers are typically removed from water using **filtration methods** like membrane filtration or granular media filtration. - The Nalgonda Technique is a chemical precipitation process not specifically designed or effective for the removal of fibrous materials like asbestos.

Q: The expected outcome of Government of India's initiative 'SUMAN' is :

Zero preventable maternal and newborn deaths. ***Zero preventable maternal and newborn deaths*** - The **SUMAN (Surakshit Matritva Aashwasan)** initiative aims to provide assured, dignified, and quality healthcare at no cost to every woman and newborn visiting a public health facility. - The ultimate goal of this comprehensive program is to eradicate all **preventable maternal and newborn deaths**, ensuring healthy outcomes for both mother and child. *Limit preventable maternal and newborn deaths to between 1 - 2%* - This percentage represents a reduction target, but not the ultimate aspirational goal of the SUMAN initiative. - The initiative's design emphasizes achieving a state where no preventable deaths occur, rather than settling for a small percentage. *Limit preventable maternal and newborn deaths to between 2 - 5%* - This range of preventable deaths is too high to be considered the desired outcome of such a comprehensive maternal and child health program. - The SUMAN initiative strives for maximum safety and care, making even 2% to 5% an unacceptable target for preventable deaths. *Limit preventable maternal and newborn deaths to between 0.5 - 1%* - While a very low percentage, this still implies that some preventable deaths would be acceptable, which contradicts the core principle of the SUMAN initiative. - The program's foundational premise is that all preventable deaths should be eliminated through quality care and intervention.

Q: Water contamination with which chemical can lead to methaemoglobinaemia?

Nitrate. ***Nitrate*** - **Nitrate** compounds in contaminated water can be reduced to **nitrites** in the gastrointestinal tract, especially in infants. - **Nitrites** oxidize the iron in **hemoglobin** from the ferrous (Fe2+) to the ferric (Fe3+) state, forming **methaemoglobin**, which cannot bind oxygen. *Sulphide* - **Sulphide** (e.g., hydrogen sulfide) poisoning primarily affects the **respiratory and nervous systems** by inhibiting cytochrome c oxidase. - It does not directly cause the formation of **methaemoglobin** as its primary mechanism of toxicity. *Fluoride* - **Fluoride** contamination is primarily associated with **dental fluorosis** (mottling of teeth) and **skeletal fluorosis** (bone and joint pain, brittle bones). - It does not directly induce **methaemoglobinaemia** as its main toxicological effect. *Cyanide* - **Cyanide** poisoning acts by inhibiting **cytochrome c oxidase** in the mitochondrial electron transport chain, leading to cellular hypoxia. - While it can impair oxygen utilization, it does not primarily cause **methaemoglobinaemia** by oxidizing hemoglobin.

Q: Consider the following disorders : 1. Delayed motor milestones 2. Spastic diplegia 3. Nyctalopia 4. Hearing defects Which of the above disorders occur as part of the spectrum of iodine deficiency disorders ?

1, 2 and 4. ***1, 2 and 4*** - **Delayed motor milestones** and **spastic diplegia** are hallmark neurological symptoms of **cretinism**, caused by severe congenital iodine deficiency. The spasticity results from pyramidal tract involvement affecting motor development. - **Hearing defects** (sensorineural deafness) are frequently observed in individuals with iodine deficiency disorders due to impaired thyroid hormone synthesis affecting inner ear development during critical developmental periods. *2, 3 and 4* - **Nyctalopia (night blindness)** is primarily associated with **Vitamin A deficiency**, not iodine deficiency. - While spastic diplegia and hearing defects are linked to iodine deficiency, the inclusion of nyctalopia makes this option incorrect. *1, 2 and 3* - This option correctly identifies delayed motor milestones and spastic diplegia as symptoms of iodine deficiency, but **nyctalopia** is an incorrect association with iodine deficiency. - Therefore, the presence of nyctalopia invalidates this choice. *1 and 3 only* - This option correctly includes **delayed motor milestones** but incorrectly includes **nyctalopia** as an iodine deficiency disorder. - It also omits other significant neurological and developmental problems like spastic diplegia and hearing defects that are part of the IDD spectrum.

Q: With reference to occupational cancers, consider the following statements : 1. Skin cancer is a common occupational hazard in workers employed in nickel and chromium work. 2. Cancer bladder is an occupational hazard in workers employed in dye-stuffs and dyeing industry. 3. Leukaemia can occur on long exposure to benzol. 4. Lung cancer is typically found in workers employed in electric cable industries. Which of the statements given above are correct ?

1, 2 and 3 only. ***1, 2 and 3 only*** - **Skin cancer** is a well-documented occupational hazard for workers exposed to compounds like **nickel and chromium**, which are known **carcinogens**. - **Bladder cancer** is strongly linked to exposure to aromatic amines found in **dye-stuffs and the dyeing industry**. - **Leukaemia** is a known risk associated with prolonged exposure to **benzene (benzol)**, a common industrial solvent. *1 and 2 only* - This option is incomplete as it correctly identifies the link between **skin cancer** and nickel/chromium exposure, and **bladder cancer** and dye-stuffs, but it omits the correct association of **leukaemia** with benzene exposure. - The statement regarding **lung cancer** in electric cable industries is generally incorrect, as lung cancer is typically associated with other occupational exposures like **asbestos** or **radon**. *2 and 3 only* - While statements 2 and 3 are correct regarding **bladder cancer** in dye industries and **leukaemia** from benzene, this option incorrectly excludes the statement about **skin cancer** in nickel and chromium work, which is also accurate. - It does not encompass all the correct occupational cancer associations presented. *1 and 4 only* - This option includes the correct association of **skin cancer** with nickel and chromium. - However, the statement regarding **lung cancer** in workers employed in electric cable industries is generally **false**, as this industry is not typically associated with a high incidence of lung cancer compared to other occupational carcinogens.

Q: Which of the following are domains (or types) of learning ? 1. Affective learning 2. Cognitive learning 3. Physiological learning 4. Psychomotor learning Select the correct answer using the code given below :

1, 2 and 4. ***Correct: 1, 2 and 4*** - The three generally recognized domains of learning are **cognitive**, **affective**, and **psychomotor**. - These domains describe the different types of learning outcomes and are used for classifying educational objectives. *Incorrect: 2, 3 and 4* - **Physiological learning** is not a standard, recognized domain of learning in educational theory. - While learning does involve physiological changes in the brain, "physiological" is not a classification for types of learning outcomes. *Incorrect: 1, 3 and 4* - This option correctly identifies affective and psychomotor learning but incorrectly includes **physiological learning** as a distinct domain. - **Cognitive learning**, which focuses on knowledge and intellectual skills, is a fundamental domain and is missing from this selection. *Incorrect: 1, 2 and 3* - This option correctly includes **affective** and **cognitive learning** but erroneously adds **physiological learning**. - It also omits **psychomotor learning**, which concerns physical skills and coordination, making it an incomplete classification of the standard learning domains.

Q: Which of the following are beneficiaries of services provided under the Integrated Child Development Scheme (ICDS) ? 1. Adolescent boys 2. Adolescent girls 3. Pregnant women 4. Children less than 6 years of age Select the correct answer using the code given below :

2, 3 and 4. ***2, 3 and 4*** - The **Integrated Child Development Services (ICDS)** scheme specifically targets **adolescent girls (11-14 years)**, **pregnant women**, and **children under 6 years of age** as primary beneficiaries. - Services include **supplementary nutrition**, **immunization**, **health check-ups**, **referral services**, **nutrition and health education**, and **pre-school education**. - Adolescent girls were included through the **Scheme for Adolescent Girls (SAG)** to address their nutritional and health needs during the critical growth phase. *1, 2 and 3* - Incorrectly includes **adolescent boys**, who are not primary beneficiaries of ICDS. - The scheme focuses on vulnerable groups with specific nutritional and reproductive health needs. *1, 3 and 4* - Incorrectly includes **adolescent boys** while excluding **adolescent girls**. - Omits **pregnant women**, who are a core beneficiary group receiving antenatal care and nutritional support. *1, 2 and 4* - Incorrectly includes **adolescent boys**. - Omits **pregnant women**, who receive crucial services including antenatal care, nutritional supplementation, and health education through ICDS.

Q: Which of the following correctly represent the critical determinants of a healthy facility being declared as a First Referral Unit (FRU) ? 1. Availability of emergency obstetric surgical interventions 2. Availability of immunization services 3. Blood storage facility 4. Newborn care Select the correct answer using the code given below :

1, 3 and 4. ***1, 3 and 4*** - A **First Referral Unit (FRU)** is a health facility equipped to provide basic and comprehensive essential obstetric and newborn care services, including **emergency obstetric surgical interventions** (like C-sections), a **blood storage facility**, and comprehensive **newborn care**. - These components are crucial for managing obstetric emergencies and ensuring the survival of mothers and newborns, which defines the core function of an FRU. *1, 2 and 3* - While immunization services are important for public health, they are not a critical determinant for classifying a facility specifically as a **First Referral Unit (FRU)**, which focuses on emergency obstetric and newborn care. - The absence of comprehensive newborn care as a listed determinant makes this option incomplete for FRU criteria. *1, 2 and 4* - This option misses the critical determinant of having a **blood storage facility**, which is essential for managing obstetric hemorrhages and is a core requirement for an FRU. - Again, **immunization services** are not a primary defining characteristic of an FRU. *2, 3 and 4* - This option incorrectly includes **immunization services** as a critical determinant while omitting **emergency obstetric surgical interventions**, which are fundamental to an FRU's ability to handle life-threatening situations during childbirth. - An FRU must be capable of performing C-sections and other emergency surgeries.

Q: What is the correct increasing order of minimum age at which the following vaccines are administered to a child, as part of the National Immunization Schedule (NIS) after birth of child ? 1. BCG vaccine 2. Japanese Encephalitis (JE) vaccine 3. Rotavirus vaccine 4. Tetanus and adult diphtheria (Td) vaccine Select the correct answer using the code given below :

1→3→2→4. **1→3→2→4** - This order reflects the standard schedule of vaccine administration in the **National Immunization Schedule (NIS)**, starting with vaccines given at birth or shortly after, followed by those administered in late infancy and early childhood, and finally those for adolescents. - The correct sequence is: **BCG at birth**, **Rotavirus at 6 weeks**, **Japanese Encephalitis at 9 months**, and **Td at 10 and 16 years**. *1→2→3→4* - This option incorrectly places the **Japanese Encephalitis (JE) vaccine** before the **Rotavirus vaccine**. The Rotavirus vaccine is typically given at 6 weeks, while JE is given later at 9 months. - The sequence of **JE** and **Rotavirus** is inverted compared to the NIS guidelines. *2→3→1→4* - This order is incorrect because it places the **BCG vaccine** after both the **Japanese Encephalitis (JE) vaccine** and the **Rotavirus vaccine**, even though BCG is administered at birth. - The early administration of **BCG** at birth is a fundamental aspect of the immunization schedule, making this sequence incorrect. *3→1→4→2* - This option incorrectly places the **Rotavirus vaccine** as the earliest, ahead of the **BCG vaccine**, which is given at birth or very soon after. - It also incorrectly places the **Td vaccine** before the **Japanese Encephalitis (JE) vaccine**, as JE is given at 9 months and Td later, in adolescence.

Question 1

Which one among the following types of ventilation, best fits the following description - "A system of ventilation in which fresh air is blown into the room by centrifugal fans so as to create a positive pressure, and displace the vitiated air" ?

Accepted Answer

Plenum ventilation

Answer

Exhaust ventilation

Answer

Balanced ventilation

Answer

Natural ventilation

Question 2

The 'Nalgonda Technique' developed by the National Environmental Engineering Research Institute (NEERI) was developed primarily for the removal of which one of the following from water ?

Accepted Answer

Fluoride

Answer

Chlorine

Answer

Iron

Answer

Asbestos

Question 3

The expected outcome of Government of India's initiative 'SUMAN' is :

Accepted Answer

Zero preventable maternal and newborn deaths

Answer

Limit preventable maternal and newborn deaths to between 1 - 2%

Answer

Limit preventable maternal and newborn deaths to between 2 - 5%

Answer

Limit preventable maternal and newborn deaths to between 0.5 - 1%

Question 4

Water contamination with which chemical can lead to methaemoglobinaemia?

Accepted Answer

Nitrate

Answer

Sulphide

Answer

Fluoride

Answer

Cyanide

Question 5

Consider the following disorders :

1. Delayed motor milestones
2. Spastic diplegia
3. Nyctalopia
4. Hearing defects
Which of the above disorders occur as part of the spectrum of iodine deficiency disorders ?

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1 and 3 only

Question 6

With reference to occupational cancers, consider the following statements :

1. Skin cancer is a common occupational hazard in workers employed in nickel and chromium work.
2. Cancer bladder is an occupational hazard in workers employed in dye-stuffs and dyeing industry.
3. Leukaemia can occur on long exposure to benzol.
4. Lung cancer is typically found in workers employed in electric cable industries. Which of the statements given above are correct ?

Accepted Answer

1, 2 and 3 only

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 4 only

Question 7

Which of the following are domains (or types) of learning ?

1. Affective learning
2. Cognitive learning
3. Physiological learning
4. Psychomotor learning
Select the correct answer using the code given below :

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 3 and 4

Answer

1, 2 and 3

Question 8

Which of the following are beneficiaries of services provided under the Integrated Child Development Scheme (ICDS) ?

1. Adolescent boys 
2. Adolescent girls 
3. Pregnant women 
4. Children less than 6 years of age

Select the correct answer using the code given below :

Accepted Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

1, 2 and 4

Question 9

Which of the following correctly represent the critical determinants of a healthy facility being declared as a First Referral Unit (FRU) ?

1. Availability of emergency obstetric surgical interventions 
2. Availability of immunization services 
3. Blood storage facility 
4. Newborn care

Select the correct answer using the code given below :

Accepted Answer

1, 3 and 4

Answer

1, 2 and 3

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 10

What is the correct increasing order of minimum age at which the following vaccines are administered to a child, as part of the National Immunization Schedule (NIS) after birth of child ?

1. BCG vaccine
2. Japanese Encephalitis (JE) vaccine
3. Rotavirus vaccine
4. Tetanus and adult diphtheria (Td) vaccine

Select the correct answer using the code given below :

Accepted Answer

1→3→2→4

Answer

1→2→3→4

Answer

2→3→1→4

Answer

3→1→4→2

UPSC-CMS 2023 — Community Medicine