UPSC-CMS 2012 - Community Medicine Practice Questions

Q: Match List-I with List-II and select the correct answer using the code given below the Lists:

A→4 B→2 C→1 D→3. ***A→4 B→2 C→1 D→3*** - This option correctly matches each committee with its primary recommendation contributing to the evolution of healthcare in India. - The **Bhore Committee** recommended **three months' training in PSM for doctors** to address basic healthcare needs, the **Mudaliar Committee** focused on **strengthening district hospitals**, the **Kartar Singh Committee** proposed the development of a **referral services complex**, and the **Srivastava Committee** suggested replacing ANMs with **female health workers**. *A→4 B→3 C→2 D→1* - This option incorrectly associates the **Mudaliar Committee** with replacing ANMs and the **Kartar Singh Committee** with strengthening district hospitals. - While both committees made significant recommendations, their specific focus areas were different from what is listed here. *A→4 B→2 C→3 D→1* - This option incorrectly links the **Kartar Singh Committee** with replacing ANMs and the **Srivastava Committee** with developing a referral services complex. - The **Kartar Singh Committee** focused on providing a comprehensive referral system, while the **Srivastava Committee** emphasized the creation of multi-purpose health workers. *A→1 B→2 C→3 D→4* - This option incorrectly matches the **Bhore Committee** with developing a referral services complex and the **Srivastava Committee** with training in PSM for doctors. - The **Bhore Committee**, formed in the 1940s, had a broader vision for healthcare infrastructure and medical education, while the **Srivastava Committee** focused on health personnel rationalization.

Q: Match List-I with List-II and select the correct answer using the code given below the Lists:

A→3 B→2 C→1 D→4. ***Correct Answer: A→3 B→2 C→1 D→4*** This option correctly matches each vector with its transmitted disease: - **A (Lice) → 3 (Epidemic Typhus fever)** - *Pediculus humanus corporis* transmits *Rickettsia prowazekii* - **B (Fleas) → 2 (Endemic Typhus fever)** - *Xenopsylla cheopis* transmits *Rickettsia typhi* - **C (Ticks) → 1 (Kyasanur Forest Disease)** - *Haemaphysalis* ticks transmit KFD virus - **D (Sand Flies) → 4 (Kala-azar)** - *Phlebotomus* species transmit *Leishmania donovani* Understanding these specific vector-disease pairings is crucial for epidemiology, disease surveillance, and vector control programs in public health. *Incorrect: A→1 B→2 C→4 D→3* - Incorrectly pairs **Lice with Kyasanur Forest Disease** (should be Epidemic Typhus) and **Ticks with Kala-azar** (should be KFD) - KFD is tick-borne, not transmitted by sand flies; Kala-azar is sand fly-borne, not tick-borne *Incorrect: A→3 B→2 C→4 D→1* - Incorrectly pairs **Ticks with Kala-azar** (should be KFD) and **Sand Flies with Kyasanur Forest Disease** (should be Kala-azar) - Reverses the correct tick and sand fly disease associations *Incorrect: A→2 B→1 C→3 D→4* - Multiple errors: **Lice with Endemic Typhus** (should be Epidemic), **Fleas with KFD** (should be Endemic Typhus), and **Ticks with Epidemic Typhus** (should be KFD) - Confuses both typhus types and mismatches the tick-borne disease entirely

Q: Which of the following is a non-modifiable risk factor for coronary heart disease ?

Age. ***Age*** - Age is a **non-modifiable risk factor** for coronary heart disease because it cannot be changed or controlled. As people age, their risk of developing CHD naturally increases due to physiological changes and increased exposure to other risk factors over time. [1] - The older an individual is, especially for men over 45 and women over 55, the higher their risk for developing **atherosclerosis** and its complications, including CHD. [1] *Elevated serum cholesterol* - **Elevated serum cholesterol**, particularly high levels of LDL cholesterol, is a **modifiable risk factor** because it can be lowered through diet, exercise, and medication. [1] - Reducing cholesterol levels can significantly decrease the risk of **atherosclerosis** and subsequent CHD. [1] *Alcoholism* - **Alcoholism** is a **modifiable risk factor** as it represents a lifestyle choice that can be changed through behavioral interventions and support. - Excessive alcohol consumption can contribute to high blood pressure, **cardiomyopathy**, and increased triglyceride levels, all of which raise the risk of CHD. *Cigarette smoking* - **Cigarette smoking** is a major **modifiable risk factor** for CHD because it is a habit that individuals can choose to stop. [1] - Smoking damages blood vessels, increases **blood clotting**, and reduces oxygen delivery to the heart, significantly accelerating the development of atherosclerosis. [1]

Q: The detection of sore throat cases in children and their treatment with Benzathine Penicillin in Community Control Programme of Rheumatic Fever/Rheumatic Heart Disease (RF/RHD) constitutes

Primary prevention of RF/RHD. ***Primary prevention of RF/RHD*** - **Early detection and treatment** of streptococcal sore throat prevents the initial episode of **acute rheumatic fever (ARF)**, thus preventing the onset of **rheumatic heart disease (RHD)**. - This intervention targets preventing the disease's **initial occurrence** by eliminating the precipitating cause. *Primordial prevention of RF/RHD* - **Primordial prevention** focuses on preventing the development of **risk factors** in the first place, often through broad social or environmental changes. - This involves strategies like improving **socioeconomic conditions** or **housing sanitation** to reduce the overall burden of streptococcal infections, rather than treating individual cases. *Tertiary prevention of RF/RHD* - **Tertiary prevention** aims to **reduce the impact** of an established disease, minimizing complications and improving quality of life. - For RF/RHD, this would involve managing **existing RHD**, such as through cardiac surgery or long-term medication, to prevent further deterioration or disability. *Secondary prevention of RF/RHD* - **Secondary prevention** involves detecting and treating a disease **early** to prevent its progression or recurrence *after* an initial episode. - In the context of RF/RHD, this would refer to **secondary prophylaxis with penicillin** given to individuals who have already had ARF to prevent subsequent attacks and progression to RHD.

Q: Which one of the following is a stomach poison for the larvae of insects of medical importance ?

Paris Green. ***Paris Green*** - **Paris Green (copper acetoarsenite)** acts as a **stomach poison** when ingested by insect larvae, particularly effective against mosquito larvae. - It is an **arsenical compound** that disrupts cellular respiration and enzyme function in the insect's digestive system. *Anti larva oil* - **Anti-larval oils** primarily act by forming a **thin film on the water surface**, preventing mosquito larvae from breathing. - This method is a **physical action** causing suffocation, rather than a stomach poison. *Pyrethrum* - **Pyrethrum** is a broad-spectrum **contact insecticide** derived from chrysanthemum flowers. - It acts on the **nervous system** of insects, causing rapid knockdown and paralysis, but is not primarily a stomach poison for larvae. *D.D.T.* - **DDT (dichlorodiphenyltrichloroethane)** is a **contact insecticide** that acts on the nervous system of insects. - It was widely used for adult mosquito control but is not typically applied as a stomach poison for larvae in a water environment.

Q: In a village, every fifth house was selected for a study. This is an example of

Systematic random sampling. ***Systematic random sampling*** - This method involves selecting subjects from a **ordered sampling frame** at regular intervals, such as every k-th item. - In this scenario, selecting every fifth house represents a fixed interval (k=5), which is characteristic of systematic random sampling. *Simple random sampling* - This method ensures that every member of the population has an **equal chance of being selected**, often through random number generation. - It does not involve a predetermined, fixed interval of selection from an ordered list. *Convenience sampling* - This technique involves selecting subjects who are **easily accessible or readily available**, without any systematic or random process. - It is prone to bias as it does not represent the entire population. *Stratified random sampling* - This method involves dividing the population into **homogeneous subgroups (strata)** and then conducting simple random sampling within each stratum. - The scenario does not describe dividing the village households into distinct subgroups before selection.

Q: In disability rates, event type indicators are the following except

Limitation of activity. ***Limitation of activity*** - While related to disability measurement, **limitation of activity** is typically classified as a **chronic disability indicator** or **impact indicator** rather than an event type indicator measured in discrete time units. - Event type indicators usually quantify disability in **specific time units (days)** representing acute episodes or events. - **Limitation of activity** describes a long-term functional status rather than countable discrete events. *Work loss days* - **Work loss days** are a standard **event type indicator** measuring days of work lost due to illness or injury. - This is a specific type of restricted activity day for the employed population. - Quantifies disability impact in discrete, countable time units (days). *Bed disability days* - **Bed disability days** directly measure severe disability events where an individual is confined to bed. - This is a classic **event type indicator** used in national health surveys. - Represents the most severe form of restricted activity days. *Number of days of restricted activity* - **Restricted activity days** are the primary **event type indicator** in disability measurement. - Quantifies days when usual activities are limited due to health conditions. - This is the broadest category of event type indicators, encompassing bed disability days and work loss days.

Q: A 9-month-old infant is brought to you for immunization. The infant has previously received the first dose of OPV and DPT. What will you do ?

Give the infant second dose of DPT/OPV. ***Give the infant second dose of DPT/OPV*** - As per the **Expanded Programme on Immunization (EPI)** guidelines, even if there's a delay, one should **continue the vaccination schedule** from where it left off, rather than restarting. - The 9-month-old is due for the **second dose of DPT and OPV**, as the first dose has already been administered. *Give the infant DT/OPV* - **DT (Diphtheria and Tetanus)** vaccine is generally given to older children who have contraindications to the pertussis component of DPT or as part of a different schedule. - At 9 months, the infant still requires the **pertussis component** for protection against whooping cough. *Repeat the first dose counting afresh* - There is **no clinical or immunological basis** for restarting the vaccination schedule (counting afresh) simply because of a delay. - Antibodies from the first dose are still present and contribute to the immune response upon subsequent doses; hence, previous doses are **considered valid**. *Give the infant a booster dose of DPT/Polio* - A **booster dose** is typically given much later in childhood (e.g., at 18 months or 5 years) to enhance and prolong immunity after the primary series is completed. - The infant first needs to **complete the primary series** of DPT and OPV, which involves a second and third dose.

Q: A randomized trial comparing the efficacy of two drugs showed a difference between the two (p value < 0.05). However, in reality the drugs do not differ. This is an example of

Type I error. ***Type I error*** - A **Type I error** occurs when the **null hypothesis is incorrectly rejected**, leading to the conclusion that a significant difference exists when, in reality, there is no true difference. - In this scenario, the trial concluded a difference (p < 0.05), but the drugs are truly equivalent, which is precisely the definition of a **Type I error**. *Both type I and II error* - It is impossible to commit both a **Type I** and a **Type II error** simultaneously for the same statistical test. - A **Type I error** involves rejecting a true null hypothesis, while a **Type II error** involves failing to reject a false null hypothesis. *Random error* - **Random error** refers to unpredictable fluctuations in measurements or results, which can be minimized but not eliminated. - While random error can contribute to variability in data, it is not the direct statistical error of concluding a non-existent difference when analyzing the results, which is a **Type I error**. *Type II error* - A **Type II error** occurs when the **null hypothesis is incorrectly accepted** (or not rejected), meaning a real difference exists but the study fails to detect it. - This scenario describes the opposite: a difference was detected and concluded, but it was false.

Q: Which one of the following formulae is used for computing the Aedes aegypti Index at International Airports and sea ports ?

Number of containers positive for Aedes aegypti breeding / Total number of containers x 100. ***Number of containers positive for Aedes aegypti breeding / Total number of containers x 100*** - The **Aedes Index (or Container Index)** specifically measures the percentage of water-holding containers found with *Aedes aegypti* larvae or pupae. - This index is crucial for assessing the **risk of dengue, Zika, and chikungunya transmission** by identifying breeding sites in areas like airports and seaports. *Number of houses positive for Aedes aegypti breeding / Total number of houses x 100* - This formula represents the **House Index**, which is a different measure of *Aedes aegypti* infestation, focusing on the percentage of houses with breeding sites. - While relevant, it is not the primary index used to assess risk at **international transit points** where containers are critical. *Number of bites of Aedes aegypti / Total number of man hours x 100* - This formula relates to **human biting rates** or **landing rates**, which assess adult mosquito activity and exposure, not the presence of breeding sites. - It does not directly measure the **potential for larval development** in containers. *Number of containers positive for Aedes aegypti breeding / Total number of houses x 100* - This formula mixes two different denominators: **containers (for positives)** and **houses (for total)**. - This is an **incorrect or hybrid formula** that does not correspond to any standard entomological index for *Aedes aegypti*.

Question 1

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→4  B→2  C→1  D→3

Answer

A→4  B→3  C→2  D→1

Answer

A→4  B→2  C→3  D→1

Answer

A→1  B→2  C→3  D→4

Question 2

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→3  B→2  C→1  D→4

Answer

A→1  B→2  C→4  D→3

Answer

A→3  B→2  C→4  D→1

Answer

A→2  B→1  C→3  D→4

Question 3

Which of the following is a non-modifiable risk factor for coronary heart disease ?

Accepted Answer

Age

Answer

Elevated serum cholesterol

Answer

Alcoholism

Answer

Cigarette smoking

Question 4

The detection of sore throat cases in children and their treatment with Benzathine Penicillin in Community Control Programme of Rheumatic Fever/Rheumatic Heart Disease (RF/RHD) constitutes

Accepted Answer

Primary prevention of RF/RHD

Answer

Primordial prevention of RF/RHD

Answer

Tertiary prevention of RF/RHD

Answer

Secondary prevention of RF/RHD

Question 5

Which one of the following is a stomach poison for the larvae of insects of medical importance ?

Accepted Answer

Paris Green

Answer

Anti larva oil

Answer

Pyrethrum

Answer

D.D.T.

Question 6

In a village, every fifth house was selected for a study. This is an example of

Accepted Answer

Systematic random sampling

Answer

Simple random sampling

Answer

Convenience sampling

Answer

Stratified random sampling

Question 7

In disability rates, event type indicators are the following except

Accepted Answer

Limitation of activity

Answer

Work loss days

Answer

Bed disability days

Answer

Number of days of restricted activity

Question 8

A 9-month-old infant is brought to you for immunization. The infant has previously received the first dose of OPV and DPT. What will you do ?

Accepted Answer

Give the infant second dose of DPT/OPV

Answer

Give the infant DT/OPV

Answer

Repeat the first dose counting afresh

Answer

Give the infant a booster dose of DPT/Polio

Question 9

A randomized trial comparing the efficacy of two drugs showed a difference between the two (p value < 0.05). However, in reality the drugs do not differ. This is an example of

Accepted Answer

Type I error

Answer

Both type I and II error

Answer

Random error

Answer

Type II error

Question 10

Which one of the following formulae is used for computing the Aedes aegypti Index at International Airports and sea ports ?

Accepted Answer

Number of containers positive for Aedes aegypti breeding / Total number of containers x 100

Answer

Number of houses positive for Aedes aegypti breeding / Total number of houses x 100

Answer

Number of bites of Aedes aegypti / Total number of man hours x 100

Answer

Number of containers positive for Aedes aegypti breeding / Total number of houses x 100

UPSC-CMS 2012 — Community Medicine