UPSC-CMS 2020 Practice Questions

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: Which is the most specific causative agent of Rabies?

Rabies lyssavirus (RABV). ***Rabies lyssavirus (RABV)*** - **Rabies lyssavirus (RABV)**, also known as the **classical rabies virus** or **genotype 1**, is the primary and most specific causative agent of rabies in humans and animals worldwide. - While other lyssaviruses (Lagos bat, Mokola, Duvenhage, Australian bat lyssavirus, etc.) can cause rabies-like illnesses, **RABV is overwhelmingly responsible** for the vast majority of documented rabies cases globally. - It is transmitted primarily through dog bites in endemic regions and causes acute, progressive, fatal encephalomyelitis. *Lagos bat lyssavirus (LBV)* - **Lagos bat lyssavirus (genotype 2)** is a distinct species within the *Lyssavirus* genus that can cause rabies-like disease, primarily in bats in Africa. - It is **rarely associated with human rabies** and is not the most common or specific cause globally. *Mokola lyssavirus (MOKV)* - **Mokola lyssavirus (genotype 3)** is another lyssavirus found in Africa, isolated from shrews, rodents, and rarely humans. - Although it can cause a fatal encephalomyelitis similar to rabies, human cases are **extremely rare**, and it is not considered the typical rabies virus. *Duvenhage lyssavirus (DUVV)* - **Duvenhage lyssavirus (genotype 4)** is a bat-associated lyssavirus found in Africa, first isolated in 1970. - Human cases are **exceptionally rare** (only a few documented cases), and it is not the primary causative agent of classic rabies.

Q: All of the following are true about Bedaquiline (BDQ) EXCEPT:

It is a bacteriostatic drug. ***It is a bacteriostatic drug*** - **Bedaquiline (BDQ)** is a novel anti-tuberculosis drug that is **bactericidal** against *Mycobacterium tuberculosis*, meaning it kills the bacteria rather than just inhibiting their growth. - Its bactericidal action is crucial for treating multi-drug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. *It has extended half-life* - **Bedaquiline** has a very **long terminal elimination half-life**, which can extend up to several months. - This extended half-life allows for less frequent dosing schedules (e.g., once daily or thrice weekly after an initial loading phase). *It specifically targets mycobacterial ATP synthase* - **Bedaquiline** specifically inhibits **mycobacterial ATP synthase**, an enzyme essential for energy production in *Mycobacterium tuberculosis* [1]. - This unique mechanism of action contributes to its effectiveness against traditional drug-resistant strains [1]. *It has high volume of tissue distribution* - **Bedaquiline** is highly lipophilic and extensively distributed into tissues, resulting in a **large volume of distribution**. - This extensive tissue distribution contributes to its long half-life and allows it to reach therapeutic concentrations within the infection sites.

Q: What is the recommended dose regimen of Vitamin A for the treatment of early stages of Xerophthalmia?

2 lac IU on two successive days. ***2 lac IU on two successive days*** - The **WHO-recommended treatment protocol** for xerophthalmia (including early stages) involves a **3-dose regimen**: 200,000 IU immediately, followed by 200,000 IU the next day, and a third dose at least 2 weeks later. - The **first two doses on consecutive days** represent the critical initial treatment phase to rapidly replenish vitamin A stores and prevent progression to sight-threatening corneal damage. - This regimen applies to children **12 months and older and adults**; infants under 12 months receive 100,000 IU doses. *Single massive dose of 2 lac International Units (IU)* - While a high dose is essential, **a single dose alone is insufficient** for treating xerophthalmia according to WHO guidelines. - The second dose on the consecutive day is critical to ensure adequate tissue saturation and prevent progression of corneal lesions. - Single-dose regimens are used for **prophylaxis in high-risk populations**, not for active treatment of xerophthalmia. *2 doses of 1 lac IU at a gap of one week* - **100,000 IU doses** are recommended for **infants under 12 months of age**, not for older children and adults with xerophthalmia. - The one-week interval does not match the WHO protocol, which requires the second dose on the **very next day** to ensure rapid correction. *2 doses of 1 lac IU in two successive days* - This dosing regimen is appropriate for **infants aged 6-12 months** with xerophthalmia, where each dose is 100,000 IU. - For children **12 months and older and adults**, the standard dose is **200,000 IU (2 lac IU)**, making this dosage insufficient for the typical patient population.

Question 1

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 2

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 3

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 4

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 5

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 6

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 7

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 8

Which is the most specific causative agent of Rabies?

Accepted Answer

Rabies lyssavirus (RABV)

Answer

Lagos bat lyssavirus (LBV)

Answer

Mokola lyssavirus (MOKV)

Answer

Duvenhage lyssavirus (DUVV)

Question 9

All of the following are true about Bedaquiline (BDQ) EXCEPT:

Accepted Answer

It is a bacteriostatic drug

Answer

It has extended half life

Answer

It specifically targets mycobacterial ATP synthase

Answer

It has high volume of tissue distribution

Question 10

What is the recommended dose regimen of Vitamin A for the treatment of early stages of Xerophthalmia?

Accepted Answer

2 lac IU on two successive days

Answer

Single massive dose of 2 lac International Units (IU)

Answer

2 doses of 1 lac IU at a gap of one week

Answer

2 doses of 1 lac IU in two successive days

UPSC-CMS 2020

Community Medicine

Microbiology

Pharmacology