UPSC-CMS 2013 Practice Questions

Q: Discarded tablets are disposed of in :

Yellow plastic bag. ***Yellow plastic bag*** - The **yellow plastic bag** is designated for **pharmaceutical waste**, which includes discarded and expired medications like tablets, as per **Bio-Medical Waste Management Rules, 2016 (India)**. - This color coding ensures that such waste is handled safely and disposed of according to **specific environmental regulations** to prevent pollution and health hazards. - Yellow bags are used for infectious waste, anatomical waste, soiled waste, expired medicines, and chemical waste. *Black plastic bag* - **Black plastic bags** are used for **general non-hazardous waste** from administrative and housekeeping areas that do not pose infection risk. - Discarding pharmaceuticals in black bags is inappropriate due to the potential for environmental contamination and health hazards. *Red plastic bag* - **Red plastic bags** are for **contaminated waste (recyclable)**, such as tubing, catheters, IV sets, and blood bags. - While some pharmaceutical waste can be hazardous, general discarded tablets are specifically categorized under yellow bag waste, not red. *Blue/White plastic bag* - **Blue or white plastic bags** are used for **sharp waste** including needles, syringes with needles, scalpels, and blades. - Discarded tablets do not fall under sharp waste category and must be disposed in yellow bags as per BMW Rules.

Q: In a village of 5,000 population, 50 persons suffered from cholera and 10 persons died. What will be the case fatality ratio?

20.0%. ***20.0%*** - The **case fatality ratio (CFR)** is calculated as the number of deaths from a specific disease divided by the number of confirmed cases of that disease, multiplied by 100. - In this scenario, 10 deaths / 50 cases = 0.2, and 0.2 * 100 = **20.0%**. *0.2%* - This value is likely derived from an incorrect calculation, possibly dividing the number of deaths by the total population, which would represent a **mortality rate**, not a case fatality ratio. - The **case fatality ratio** specifically relates deaths to the number of *cases*, not the entire population. *5.0%* - This calculation might be a misinterpretation of the formula or an application of the wrong denominator. - The correct denominator for **case fatality ratio** is the number of **cases**, not the total population or a subset of it unrelated to the disease. *1.0%* - This percentage would result from a different set of numbers for deaths and cases, or an error in calculation. - The **case fatality ratio** is focused on the severity of the disease among those who *contract* it, not the prevalence in the general population.

Q: One of the following diseases has more than one route of transmission :

Influenza. ***Influenza*** - Influenza is primarily transmitted through **respiratory droplets** produced when an infected person coughs or sneezes. - It can also be spread by touching contaminated surfaces with the virus and then touching one's **mouth, nose, or eyes**. *Leprosy* - Leprosy is primarily transmitted through **prolonged, close contact** with an infected individual who is not undergoing treatment, via respiratory droplets from the nose and mouth. - It is not known to be transmitted through multiple, distinct routes beyond this **respiratory droplet transmission**. *Cholera* - Cholera is exclusively transmitted through the **fecal-oral route**, typically by consuming water or food contaminated with *Vibrio cholerae* bacteria. - There is no evidence of routine transmission via **respiratory droplets** or direct contact among humans. *Typhoid fever* - Typhoid fever is primarily transmitted via the **fecal-oral route**, through contaminated food or water with *Salmonella Typhi*. - While it has a single route of transmission, the means of contamination can vary, e.g., via **contaminated food handlers** or **poor sanitation**.

Q: Serial interval is the gap between :

Primary and secondary case. ***Primary and secondary case*** - The **serial interval** is defined as the time between the onset of symptoms in a **primary case** and the onset of symptoms in a **secondary case** infected by the primary case. - It is a crucial epidemiological parameter used to estimate the **reproduction number (R)** of infectious diseases. *Index and primary case* - The **index case** is the first case identified in an outbreak, while the **primary case** is the actual first case to get the disease. These two might not always be the same. - The serial interval specifically links the source of transmission (primary case) to the recipient (secondary case) based on symptom onset. *Introduction of infection and development of maximum infectivity* - This describes the **incubation period** or a phase within it, not the serial interval. - The serial interval measures the time between symptomatic onsets in a transmission chain. *Transmission of infection from patient to another susceptible host* - This describes the event of **actual transmission**, but the serial interval is the time duration between the manifestation of symptoms in the two individuals involved in this transmission. - It focuses on the time between **symptom onset**, not the time of transmission itself.

Q: Vision 2020 India includes all of the following except :

Epidemic conjunctivitis. ***Epidemic conjunctivitis*** - Vision 2020 India primarily focuses on **preventable causes of permanent blindness** and severe visual impairment. - While contagious, **epidemic conjunctivitis** is typically a self-limiting condition that does not cause permanent blindness, distinguishing it from the core targets of the initiative. *Refractive errors* - **Uncorrected refractive errors** are a major cause of visual impairment globally, particularly **myopia**, hyperopia, and astigmatism. - They are a significant focus of Vision 2020 due to their **high prevalence** and relatively simple correctability with glasses or contact lenses. *Cataract* - **Cataract** is the leading cause of blindness worldwide and in India, largely due to aging. - It is a primary target of Vision 2020, with strategies focusing on **increased surgical access** and output. *Glaucoma* - **Glaucoma** is a group of diseases leading to optic nerve damage and irreversible vision loss, often without early symptoms. - Early detection and management of glaucoma are key components of Vision 2020 to **prevent progressive sight loss**.

Q: The most sensitive index for surveillance of malaria transmission is :

Spleen rate. ***Spleen rate*** - The **spleen rate** (percentage of children 2-9 years old with palpable splenomegaly) is the most sensitive and cost-effective index for **long-term surveillance of malaria transmission**, particularly in endemic areas. - An enlarged spleen is a common manifestation of **chronic malaria infection**, reflecting repeated exposure and immune response. *Infant parasite rate* - While helpful, the **infant parasite rate**, which measures parasites in infants, may not capture the full burden of transmission across all age groups or long-term trends. - It primarily indicates **recent or ongoing transmission** affecting the most vulnerable population. *Parasite density index* - **Parasite density index** is a measure of the number of parasites per unit volume of blood in infected individuals. - It is crucial for assessing **individual infection severity** and drug efficacy but is less suitable as a sole population-level surveillance tool for overall transmission dynamics. *Proportional case rate* - The **proportional case rate** measures the proportion of all reported cases that are malaria-related. - This index is influenced heavily by **diagnosis and reporting biases** and may not accurately reflect true transmission intensity.

Q: Integrated management of neonatal and childhood illness includes all except :

Tuberculosis. ***Tuberculosis*** - While tuberculosis can significantly affect children, especially in endemic areas, it is typically managed under **separate, specialized programs** (such as the National TB Elimination Programme) due to its **chronic nature**, specific diagnostic requirements (including tuberculin skin testing, chest X-rays, and microbiological investigations), and prolonged treatment regimens (6-12 months with multiple drugs). - The **Integrated Management of Neonatal and Childhood Illness (IMNCI)** strategy focuses on acute, common childhood illnesses that require rapid assessment and standardized treatment protocols, which differ fundamentally from the comprehensive, long-term management approach required for TB. - TB screening may be part of child health programs, but the actual management follows dedicated TB control protocols rather than IMNCI guidelines. *Pneumonia* - **Pneumonia** is a core component of the IMNCI strategy because it is a leading cause of childhood mortality worldwide and requires standardized assessment for danger signs, fast breathing, and chest indrawing. - IMNCI provides clear protocols for classifying and managing **acute respiratory infections** with appropriate antibiotic therapy based on severity. *Diarrhoea* - **Diarrhoea** is a major focus of IMNCI as it causes significant dehydration and mortality in young children. - IMNCI includes protocols for assessing dehydration status, providing oral rehydration therapy (ORT), administering zinc supplementation, and managing persistent diarrhea and dysentery. *Malaria* - In malaria-endemic regions, **malaria** is integrated into IMNCI with guidelines for rapid diagnostic testing (RDTs) or clinical diagnosis based on fever patterns. - IMNCI helps healthcare workers quickly identify and treat uncomplicated malaria in children with appropriate antimalarials to reduce morbidity and mortality.

Q: Toxic shock syndrome occurs after one of the following vaccinations :

DPT. ***DPT*** - Toxic shock syndrome has been **extremely rarely reported in isolated case reports following DPT** (diphtheria, pertussis, tetanus) vaccination, though it is **not a recognized or established complication** in standard medical literature. - The association is controversial and based on very limited data. Any potential link may be related to coincidental bacterial infection rather than a direct vaccine effect. - Among the options listed, this has the most (though minimal) reported association with **TSS-like reactions** in historical case reports. *Measles vaccine* - The measles vaccine is a **live attenuated vaccine** and does not cause toxic shock syndrome. - Its adverse effects are usually related to a mild form of the disease or allergic reactions, not **bacterial toxin-mediated illnesses like TSS**. *BCG vaccine* - The BCG (Bacille Calmette-Guérin) vaccine is used against tuberculosis and is a **live attenuated vaccine**. - Adverse effects are commonly local reactions or disseminated BCG disease in immunocompromised individuals, not **toxic shock syndrome**. *Recombinant DNA Vaccine against Hepatitis B* - Recombinant DNA vaccines, like the Hepatitis B vaccine, are highly purified and contain **no live pathogens or bacterial toxins**. - They are associated with very few severe adverse events, none of which include **toxic shock syndrome**.

Q: What is the method of sampling in which the units are picked up at regular intervals from the universe ?

Systematic random sampling. ***Systematic random sampling*** - This method involves selecting samples at a **fixed and regular interval** from a larger population after a random starting point is chosen. - It ensures representation across the entire population list by picking every nth unit, making it **efficient for large datasets**. *Stratified random sampling* - This method involves dividing the population into **homogeneous subgroups** (strata) and then drawing a random sample from each stratum. - It is used when there is a need to ensure **representation of specific subgroups**, which is not the primary characteristic described. *Snow-ball sampling* - This is a **non-probability sampling technique** where initial subjects recruit future subjects from among their acquaintances, typically used for hard-to-reach populations. - It relies on existing social networks and is not characterized by picking units at regular intervals. *Simple random sampling* - In this method, every member of the population has an **equal chance of being selected**, and selections are made fully at random. - While random, it does not involve the specific process of picking units at **regular, predetermined intervals**.

Q: Apgar score is used in:

Newborn assessment. ***Newborn assessment*** - The **Apgar score** is a standardized clinical assessment tool used to evaluate the **physical condition of newborn infants** immediately after birth. - Developed by Dr. Virginia Apgar in 1952, it assesses five parameters at **1 minute and 5 minutes** after delivery (extended to 10, 15, and 20 minutes if needed). - The five components assessed are: - **A**ppearance (skin color): 0-2 points - **P**ulse (heart rate): 0-2 points - **G**rimace (reflex irritability): 0-2 points - **A**ctivity (muscle tone): 0-2 points - **R**espiration (breathing effort): 0-2 points - **Total score ranges from 0-10**, with scores of 7-10 considered normal, 4-6 indicating moderate distress, and 0-3 indicating severe distress requiring immediate resuscitation. - It helps **identify neonates requiring immediate medical intervention** and provides a standardized method for documenting the newborn's transition to extrauterine life. *Maternal health assessment* - Maternal health is assessed using different tools such as **antenatal risk scoring systems**, blood pressure monitoring, and laboratory investigations. - The Apgar score is specifically designed for **neonates, not mothers**. *Nutritional status evaluation* - Nutritional status is assessed using anthropometric measurements like **weight-for-height, BMI, MUAC** (mid-upper arm circumference), and biochemical markers. - The Apgar score does not evaluate nutritional parameters. *Infectious disease severity grading* - Infectious disease severity uses specific scoring systems like **APACHE II, SOFA score, or disease-specific criteria** (e.g., WHO classification for dengue severity). - The Apgar score is a **neonatal assessment tool**, not used for infectious disease evaluation.

Question 1

Discarded tablets are disposed of in :

Accepted Answer

Yellow plastic bag

Answer

Black plastic bag

Answer

Red plastic bag

Answer

Blue plastic bag

Question 2

In a village of 5,000 population, 50 persons suffered from cholera and 10 persons died. What will be the case fatality ratio?

Accepted Answer

20.0%

Answer

0.2%

Answer

5.0%

Answer

1.0%

Question 3

One of the following diseases has more than one route of transmission :

Accepted Answer

Influenza

Answer

Leprosy

Answer

Cholera

Answer

Typhoid fever

Question 4

Serial interval is the gap between :

Accepted Answer

Primary and secondary case

Answer

Index and primary case

Answer

Introduction of infection and development of maximum infectivity

Answer

Transmission of infection from patient to another susceptible host

Question 5

Vision 2020 India includes all of the following except :

Accepted Answer

Epidemic conjunctivitis

Answer

Refractive errors

Answer

Cataract

Answer

Glaucoma

Question 6

The most sensitive index for surveillance of malaria transmission is :

Accepted Answer

Spleen rate

Answer

Infant parasite rate

Answer

Parasite density index

Answer

Proportional case rate

Question 7

Integrated management of neonatal and childhood illness includes all except :

Accepted Answer

Tuberculosis

Answer

Pneumonia

Answer

Diarrhoea

Answer

Malaria

Question 8

Toxic shock syndrome occurs after one of the following vaccinations :

Accepted Answer

DPT

Answer

Measles vaccine

Answer

BCG vaccine

Answer

Recombinant DNA Vaccine against Hepatitis B

Question 9

What is the method of sampling in which the units are picked up at regular intervals from the universe ?

Accepted Answer

Systematic random sampling

Answer

Stratified random sampling

Answer

Snow-ball sampling

Answer

Simple random sampling

Question 10

Apgar score is used in:

Accepted Answer

Newborn assessment

Answer

Maternal health assessment

Answer

Nutritional status evaluation

Answer

Infectious disease severity grading

UPSC-CMS 2013

Community Medicine

Pediatrics