UPSC-CMS 2014 - Community Medicine Practice Questions

Q: ‘Spot map’ in epidemiological studies refer to variation in the distribution of a disease at:

Local level. ***Local level*** - A **spot map** is an epidemiological tool used to visualize the geographical distribution of disease cases within a **small, defined area**, such as a neighborhood or a single city. - It helps in identifying **clusters or hot-spots** of disease occurrence, which can be crucial for locating potential sources of infection or environmental hazards. *International level* - While disease distribution can be mapped internationally, a "spot map" specifically refers to a **finer-grain analysis** at a much smaller geographical scale, not across multiple countries. - Maps at the international level are often used for **global burden of disease** studies or pandemic tracking, which require broader summaries rather than individual case plotting. *Rural – urban level* - Mapping at the rural-urban level indicates differences between these two broad categories, but a spot map provides even more specific detail within those areas. - It shows the precise location of cases, allowing for insights into localized environmental or social factors, rather than just a general rural vs. urban comparison. *National level* - National-level mapping provides an overview of disease prevalence or incidence across an entire country, which is a much larger scale than a spot map. - A spot map is designed to highlight **precise locations** of cases within a more contained geographical area, making it less suitable for broad national-level trends.

Q: Iodine can be used for the disinfection of which of the following? 1. Water 2. Faeces 3. Urine 4. Skin Select the correct answer using the code given below:

1 and 4 only. ***1 and 4 only*** - **Iodine is highly effective for water disinfection**, particularly in emergency and travel situations, killing bacteria, viruses, and protozoa - **Povidone-iodine is a standard antiseptic for skin disinfection** used pre-operatively, for wound care, and before injections due to its broad-spectrum antimicrobial activity - These are the two established and recommended uses of iodine for disinfection in medical and public health practice *1, 3 and 4* - While iodine effectively disinfects water and skin, it is **not used for urine disinfection** - Urine from healthy individuals is typically sterile and does not require routine disinfection - If disinfection of contaminated urine is needed (rare situations), other chemical agents would be preferred *1, 2 and 3* - Iodine is effective for water disinfection but **not suitable for faecal matter disinfection** - Faeces requires stronger disinfection methods: **chlorine-based compounds (sodium hypochlorite/bleach)**, heat treatment, or proper sewage treatment systems - Iodine is impractical and ineffective for the high pathogen load in faecal waste *1 only* - This option incorrectly excludes skin disinfection, which is **one of the most common applications of iodine** in medical practice - Povidone-iodine solutions (Betadine) are standard antiseptics used worldwide for skin preparation before surgical procedures

Q: Consider the following: 1. Standard deviation 2. Range 3. Mode 4. Median Among the above, which is/are the measure/measures of dispersion?

1 and 2 only. ***1 and 2 only*** - The **standard deviation** quantifies the average amount of variability or dispersion around the mean, representing how spread out the data points are. - The **range** is the difference between the maximum and minimum values in a dataset, providing a simple measure of the total spread. *3 and 4 only* - The **mode** represents the most frequently occurring value in a dataset, which is a measure of central tendency, not dispersion. - The **median** is the middle value when data is ordered, also a measure of central tendency. *1 only* - While **standard deviation** is a measure of dispersion, this option incorrectly excludes the **range**, which also quantifies data spread. - Both **standard deviation** and **range** are fundamental measures used to describe the variability within a dataset. *1, 2, 3 and 4* - This option incorrectly includes the **mode** and **median**, which are measures of **central tendency**, not dispersion. - Measures of dispersion specifically describe the **spread or variability** of data, whereas central tendency measures describe the center of the data.

Q: Which of the following diseases has man as an incidental host with ‘Pig → Mosquito → Pig’ as the basic cycle of transmission?

Japanese encephalitis. ***Japanese encephalitis*** - **Japanese encephalitis** is a viral disease where humans are incidental dead-end hosts. - The established transmission cycle involves **pigs as amplifying hosts** and mosquitoes (primarily *Culex tritaeniorhynchus*) as vectors, which then infect other pigs, maintaining the "Pig → Mosquito → Pig" cycle. - Water birds serve as natural reservoir hosts, while pigs amplify the virus. *Handigodu syndrome* - **Handigodu disease** is another name for **Kyasanur Forest Disease (KFD)** or a related viral hemorrhagic fever from the same region in Karnataka, India. - It is a tick-borne viral disease, not mosquito-borne, with monkeys and small mammals as reservoir hosts. - There is no "Pig → Mosquito → Pig" transmission cycle involved. *Chikungunya* - **Chikungunya** is a viral disease transmitted primarily by *Aedes aegypti* and *Aedes albopictus* mosquitoes, with humans being the primary reservoir hosts. - The transmission cycle is "Human → Mosquito → Human," not involving pigs as amplifying hosts. *Kyasanur forest disease* - **Kyasanur forest disease (KFD)** is a viral hemorrhagic fever transmitted by *Haemaphysalis* ticks, with monkeys and small mammals serving as reservoir hosts. - The transmission cycle involves ticks and forest animals, not pigs and mosquitoes, and humans are incidental hosts.

Q: A screening programme for school children was undertaken with the following results: 1. 30% boys and 60% girls were found to be anemic 2. 50% children had history of passing worms in stool 3. 10% children had poor vision 4. 5% children had enlarged tonsils In this context, which of the following is not an appropriate follow up activity?

Referring those children with enlarged tonsils for surgery. ***Referring those children with enlarged tonsils for surgery*** - Only **5%** of children had enlarged tonsils, and many cases of enlarged tonsils are **asymptomatic** and do not require surgery. - **Tonsillectomy** is a surgical procedure with risks and is typically reserved for recurrent infections or significant airway obstruction, which is not indicated by simple enlargement. *Providing iron supplementation to all children* - A significant proportion of children (30% boys, 60% girls) were found to be **anemic**, making universal iron supplementation a reasonable public health intervention to address widespread nutritional deficiency. - Iron deficiency is common in school-aged children and can impact **cognitive development** and physical performance. *Administering mass deworming medication to all children* - **50%** of children had a history of passing worms in stool, indicating a high prevalence of **intestinal helminthiasis** in the school population. - **Mass deworming** is a cost-effective public health strategy in areas with high prevalence to reduce the burden of worm infections and improve child health outcomes. *Prescribing corrective spectacles to children with poor vision* - **10%** of children had poor vision, a significant percentage that warrants intervention. - Providing **corrective spectacles** is an appropriate and effective follow-up to address refractive errors, which are a common cause of poor vision in children and can impact academic performance.

Q: Sullivan’s index is an indicator of:

Disability. ***Disability*** - Sullivan's index, also known as **disability-free life expectancy**, is a measure that combines **mortality** and **morbidity** data to estimate the expected years an individual will live without disability. - It's a key indicator of the average number of years a person can expect to live in a **healthy or non-disabled state.** *Morbidity* - While related to morbidity, Sullivan's index specifically measures the **absence of disability**, rather than just the presence of disease or illness. - **Morbidity** refers to the state of being diseased or unhealthy, without necessarily quantifying the impact on daily function. *Mortality* - **Mortality** refers to the death rate or the number of deaths in a population. Sullivan's index uses mortality data in its calculation but is not solely an indicator of mortality. - It combines mortality with information on disability to provide a more nuanced picture of **population health.** *Health care delivery* - **Health care delivery** refers to the organization and provision of medical services. Sullivan's index measures health outcomes and does not directly indicate the quality or efficiency of healthcare delivery systems. - While improved healthcare can influence disability-free life expectancy, the index itself is a **health status measure**, not a healthcare system measure.

Q: Which one of the following mosquitoes is responsible for transmitting Japanese encephalitis?

Culex tritaeniorhynchus. ***Culex tritaeniorhynchus*** - This mosquito species is the **primary vector** for **Japanese encephalitis virus (JEV)** transmission in many endemic regions of Asia. - It typically breeds in **rice paddies** and other agricultural water sources, allowing for efficient transmission within populations. *Aedes aegypti* - This mosquito is the main vector for **Dengue**, **Chikungunya**, and **Zika** viruses. - It is not a significant vector for Japanese encephalitis. *Anopheles stephensi* - This mosquito is a major vector for **malaria**, particularly in urban areas of India. - It primarily transmits **Plasmodium parasites** and is not associated with Japanese encephalitis. *Mansonia* - Mosquitoes of the *Mansonia* genus are known vectors for **lymphatic filariasis** and some arboviruses. - They are not considered primary vectors for Japanese encephalitis.

Q: The primary route of administration of measles vaccination is:

Subcutaneous. ***Subcutaneous*** - The **measles, mumps, and rubella (MMR) vaccine** is a live attenuated vaccine typically administered via the **subcutaneous route**. - Subcutaneous injection ensures the vaccine is delivered into the fatty tissue just below the skin, allowing for gradual absorption and an effective immune response. *Intravenous* - **Intravenous administration** delivers substances directly into the bloodstream, which is generally avoided for vaccines due to the risk of systemic reactions and rapid clearance. - This route is typically reserved for emergency medications or those requiring immediate systemic distribution. *Intranasal* - **Intranasal vaccines** are administered through the nasal passages and are designed to stimulate mucosal immunity, particularly against respiratory pathogens. - While some flu vaccines use this route, the standard measles vaccine does not. *Intradermal* - **Intradermal administration** involves injecting into the dermis layer of the skin, often used for sensitivity testing or certain vaccines like BCG. - This route requires a smaller volume and specific technique, which is not the primary method for routine measles vaccination.

Question 1

‘Spot map’ in epidemiological studies refer to variation in the distribution of a disease at:

Accepted Answer

Local level

Answer

International level

Answer

Rural – urban level

Answer

National level

Question 2

Specificity of a test is =

Accepted Answer

(True negatives X 100) / (True negatives + False positives) %

Answer

(True positives X 100) / (True negatives + False positives) %

Answer

(True positives X 100) / (True positives + False negatives) %

Answer

(True negatives X 100) / (True positives + True negatives) %

Question 3

With reference to historical cohort study, which of the following statements is not correct?

Accepted Answer

Control subjects are selected from the current population without exposure.

Answer

Duration of study is shorter as compared to current cohort study.

Answer

Experience of cohort is assessed from existing records.

Answer

Outcomes have occurred before the start of the investigation.

Question 4

Iodine can be used for the disinfection of which of the following?

1. Water
2. Faeces
3. Urine
4. Skin
Select the correct answer using the code given below:

Accepted Answer

1 and 4 only

Answer

1, 3 and 4

Answer

1, 2 and 3

Answer

1 only

Question 5

Consider the following:

1. Standard deviation
2. Range
3. Mode
4. Median

Among the above, which is/are the measure/measures of dispersion?

Accepted Answer

1 and 2 only

Answer

3 and 4 only

Answer

1 only

Answer

1, 2, 3 and 4

Question 6

Which of the following diseases has man as an incidental host with ‘Pig → Mosquito → Pig’ as the basic cycle of transmission?

Accepted Answer

Japanese encephalitis

Answer

Handigodu syndrome

Answer

Chikungunya

Answer

Kyasanur forest disease

Question 7

A screening programme for school children was undertaken with the following results:

1. 30% boys and 60% girls were found to be anemic
2. 50% children had history of passing worms in stool
3. 10% children had poor vision
4. 5% children had enlarged tonsils

In this context, which of the following is not an appropriate follow up activity?

Accepted Answer

Referring those children with enlarged tonsils for surgery

Answer

Providing iron supplementation to all children

Answer

Administering mass deworming medication to all children

Answer

Prescribing corrective spectacles to children with poor vision

Question 8

Sullivan’s index is an indicator of:

Accepted Answer

Disability

Answer

Morbidity

Answer

Mortality

Answer

Health care delivery

Question 9

Which one of the following mosquitoes is responsible for transmitting Japanese encephalitis?

Accepted Answer

Culex tritaeniorhynchus

Answer

Aedes aegypti

Answer

Anopheles stephensi

Answer

Mansonia

Question 10

The primary route of administration of measles vaccination is:

Accepted Answer

Subcutaneous

Answer

Intravenous

Answer

Intranasal

Answer

Intradermal

UPSC-CMS 2014 — Community Medicine