UPSC-CMS 2025 - Community Medicine Practice Questions

Q: What are the reasons for choosing coliform organisms as indicators of faecal pollution of water rather than the waterborne pathogens directly? I. They are present in great abundance in the human intestine and excreted in great numbers in faeces. II. They have lower resistance to forces of natural purification. III. They survive lesser than the pathogens. IV. They are easily detected by culture methods. Select the correct answer using the code given below :

I and IV. ***I and IV*** - **Coliforms** are found in abundance in the human intestine and are excreted in large numbers, making their presence a reliable indicator of potential fecal contamination. - They are also relatively **easy to detect** using standard culture methods, which allows for rapid and cost-effective testing of water quality. *II and III* - This statement is incorrect because coliforms generally have **higher resistance** to environmental stresses and **survive longer** in water than many fastidious waterborne pathogens. - If coliforms survived less than pathogens, their absence would not guarantee the absence of more resilient harmful organisms. *I only* - While statement I is correct, it does not fully encompass all the critical reasons for using coliforms as indicators. The **ease of detection** (statement IV) is equally crucial for their practical application. - Relying solely on abundance would make monitoring less efficient without practical and rapid detection methods. *IV only* - While statement IV is correct, it fails to mention the critical aspect of **coliform abundance** in feces, which makes them a meaningful indicator. - The ease of detection alone wouldn't make them suitable if they weren't consistently present in fecal matter.

Q: The Ministry of Health and Family Welfare has launched a programme to meet the challenge of high prevalence of anaemia amongst adolescent boys and girls. Consider the following statements in relation to the key interventions being undertaken : I. It entails supervised weekly administration of 100 mg elemental iron and 500 mu g folic acid. II. These weekly iron-folic acid supplements are administered by using a fixed day approach. III. It entails supervised administration of Albendazole 400 mg every three months for control of helminth infestation. Which of the statements given above is/are correct?

I and II. ***Correct: I and II*** - The **Weekly Iron and Folic Acid Supplementation (WIFS)** program targets adolescent boys and girls for anaemia control - **Statement I is correct:** The program involves supervised weekly administration of **100 mg elemental iron** and **500 μg folic acid** - **Statement II is correct:** Supplements are administered using a **fixed-day approach** (e.g., every Wednesday) to ensure adherence and systematic implementation - Both statements accurately reflect the core interventions of the WIFS program *Incorrect: I only* - This is incomplete as it excludes Statement II, which describes the crucial fixed-day implementation strategy - While the supplementation dosage is correct, the delivery mechanism (fixed day) is equally important *Incorrect: II only* - This misses the essential component of the actual supplementation (iron and folic acid dosage) - The fixed-day approach alone without the supplementation details is incomplete *Incorrect: I and III* - **Statement III is incorrect:** Albendazole 400 mg for deworming is administered **twice yearly (every 6 months)**, NOT every 3 months - While deworming is part of the comprehensive WIFS strategy, the frequency stated in Statement III is inaccurate - Only Statement I is correct in this combination

Q: Under the Pradhan Mantri Surakshit Matritva Abhiyan, the beneficiaries are being provided with a minimum package of antenatal care including certain investigations and drugs on a fixed day of every month. Which day of the month is specified for this purpose?

9th day of the month. ***9th day of the month*** - The **Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)** specifies the **9th of every month** as the day for providing comprehensive antenatal care to pregnant women. - This fixed day ensures that women can reliably access free antenatal health check-ups and necessary services. *1st day of the month* - The 1st day of the month is not designated for the PMSMA check-ups; a specific date was chosen to streamline the program's implementation. - While other health initiatives may occur on the 1st, **antenatal care under PMSMA** is not among them. *7th day of the month* - The 7th day of the month is not the designated date for the **PMSMA antenatal care package**. - No specific national maternal health program utilizes the 7th day for regular check-ups. *15th day of the month* - The PMSMA program does not specify the 15th day for its antenatal care services; the focus is on a consistent, predictable schedule for beneficiaries. - While mid-month check-ups are generally important, this specific initiative uses a distinct date.

Q: In the most widespread calculation of Stillbirth Rate, the numerator is defined as foetal deaths weighing 'X' grams or more at birth, during the year. Which one of the following is the correct value for 'X'?

1000. ***1000*** - The international standard for defining a **stillbirth**, for statistical purposes, often uses a cutoff of **1000 grams** or **28 weeks of gestation**. - This weight threshold helps to standardize reporting across different regions and healthcare systems for calculating the **Stillbirth Rate**. *750* - While some classifications might use similar weights for specific research or local definitions, **750 grams** is not the universally accepted weight for stillbirth reporting in the most widespread calculations. - This weight is sometimes used as a lower threshold for viability or extreme prematurity, but not typically for the primary stillbirth definition. *1500* - A weight of **1500 grams** would exclude a significant number of stillbirths that are included under the more widely accepted 1000-gram definition. - This higher threshold would lead to an underestimation of the true stillbirth rate in a population. *500* - A threshold of **500 grams** is often used in the definition of a **fetal death** but not specifically for the widespread calculation of the **Stillbirth Rate**. - Foetal deaths below 1000 grams are often considered early fetal deaths and may be reported separately or not included in the primary stillbirth rate, depending on the specific reporting system.

Q: While performing triage in response to a disaster emergency, commonly an internationally accepted four-colour code system is used. Which one among the following four-colour categories represents the highest priority for emergency response ?

Red. ***Red*** - The **red** category is assigned to patients with **immediate, life-threatening injuries** who have a high probability of survival with prompt medical intervention. - This color signifies the **highest priority** for medical treatment and transport to maximize their chances of survival. *Green* - The **green** category is for patients with **minor injuries** that are not life-threatening and can wait for medical attention. - These individuals are often referred to as walking wounded and can typically self-evacuate or wait for more critical patients to be treated. *Black* - The **black** category is reserved for patients who are either **deceased** or have injuries so severe that survival is unlikely, even with immediate medical care. - In a mass casualty situation, resources are generally not allocated to these individuals to prioritize those with a higher chance of survival. *Yellow* - The **yellow** category is for patients with **significant injuries** that are not immediately life-threatening but require definitive medical care within a few hours. - These patients are considered "delayed" and their treatment can be postponed until after red-category patients have been managed.

Q: Consider the following statements with regard to Ice-Lined Refrigerator (ILR) employed for storing vaccines at the sub-district level : I. These types of refrigerators are top-opening. II. Based on the temperature zone, the inside of ILRs can be divided into 3 parts. III. The upper part of ILR is cooler compared to the lower part. IV. Vaccines should never be kept directly on the floor of the ILR as they can get damaged. Which of the statements given above are correct?

II and III. ***II and IV*** - **Statement II is correct**: ILRs can be divided into **3 temperature zones** based on cold air distribution: - **Upper zone** (near door): Warmest area - **Middle zone**: Optimal temperature (2-8°C) for vaccine storage - **Lower zone/floor**: Coldest area with risk of freezing - **Statement IV is correct**: Vaccines should **never be placed directly on the floor** of the ILR as this is the coldest zone where temperatures can drop below 0°C, causing **freeze damage** to vaccines like DPT, Hepatitis B, and TT which are freeze-sensitive. *I and III* - **Statement I is incorrect**: ILRs used at sub-district level in India's Universal Immunization Programme are **front-opening** (not top-opening) refrigerators. Top-opening freezers may be used for ice-pack preparation, but vaccine storage ILRs are front-opening. - **Statement III is incorrect**: The **lower part is cooler** than the upper part, not the opposite. Cold air sinks, making the floor area the coldest zone (prone to freezing), while the upper area near the door is relatively warmer.

Q: Which one of the following terms is an "all-or-none phenomenon" and is best described as termination of all transmission of infection by extermination of the infectious agent?

Disease eradication. ***Disease eradication*** - **Eradication** means the permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts, with no risk of reintroduction. - It is an "**all-or-none phenomenon**" because the infectious agent is completely exterminated globally, signifying a definitive end to transmission. *Disease surveillance* - **Disease surveillance** is the ongoing systematic collection, analysis, interpretation, and dissemination of health data essential to the planning, implementation, and evaluation of public health practice. - It does not involve the termination or extermination of an infectious agent but rather monitors its spread and impact. *Disease elimination* - **Elimination** refers to the reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts. - While local transmission is stopped, the infectious agent may still exist elsewhere, meaning there is still a risk of reintroduction. *Disease control* - **Disease control** involves ongoing public health efforts to reduce the incidence, prevalence, morbidity, and mortality of an infectious disease to a locally acceptable level. - It focuses on managing and reducing the burden of disease, not necessarily eradicating the causative agent.

Q: "Objectives are set forth for different units and subunits, each of which prepares its own plan of action, usually on a short-term basis." The definition best sums up which one among the following terms?

Management by objectives. ***Management by objectives*** - This definition directly describes **Management by Objectives (MBO)**, where clear objectives are set at various levels, and action plans are developed to achieve them. - MBO emphasizes a **participative approach** where employees and managers collaborate to set realistic and achievable goals, often on a short-term basis. *Input-Output analysis* - **Input-Output analysis** studies the interdependencies within an economy, detailing how the output of one industry serves as input for another. - It does not focus on goal-setting and planning for different organizational units. *Personnel management* - **Personnel management** deals with the administrative aspects of employee relations, such as recruitment, training, compensation, and employee welfare. - While it involves setting objectives related to human resources, it is not the overarching definition for setting objectives across different units and subunits with associated action plans. *Work sampling* - **Work sampling** is a method used to determine the proportion of time spent by workers on different tasks over a period. - It is a tool for **measuring work activities** and efficiency, not a framework for objective setting and action planning within an organization.

Q: In the context of rural healthcare delivery in India, the Panchayati Raj system plays a crucial role in implementing health programs at the grassroots level. Consider the following bodies and their involvement in village-level health initiatives: I. Gram Sabha - Village health planning and monitoring II. Gram Panchayat - Implementation of health schemes and sanitation III. Nyaya Panchayat - Health-related dispute resolution IV. Panchayat Samiti - Block-level health program coordination Which of the above bodies are present and actively involved in healthcare delivery at the village level?

I and II only. ***I and II only*** - The **Gram Sabha** is responsible for **village health planning** and monitoring, ensuring community participation in health initiatives. - The **Gram Panchayat** undertakes the **implementation of health schemes** and plays a vital role in sanitation and environmental health at the village level. *I, II and III* - While I and II are correct, the **Nyaya Panchayat** is primarily involved in **justice delivery and dispute resolution**, not active healthcare delivery. - Its role in healthcare is indirect, often related to settling disputes arising from health-related issues, rather than direct program implementation. *III and IV only* - **Nyaya Panchayat** (III) is not directly involved in healthcare delivery at the village level. - **Panchayat Samiti** (IV) operates at the **block level**, not the village level, though it coordinates health programs that impact villages. *II, III and IV* - The **Nyaya Panchayat** (III) does not have a direct role in healthcare delivery. - The **Panchayat Samiti** (IV) functions at the **block level**, not the village level.

Question 1

What are the reasons for choosing coliform organisms as indicators of faecal pollution of water rather than the waterborne pathogens directly?
I. They are present in great abundance in the human intestine and excreted in great numbers in faeces.
II. They have lower resistance to forces of natural purification.
III. They survive lesser than the pathogens.
IV. They are easily detected by culture methods.
Select the correct answer using the code given below :

Accepted Answer

I and IV

Answer

II and III

Answer

I only

Answer

IV only

Question 2

The Ministry of Health and Family Welfare has launched a programme to meet the challenge of high prevalence of anaemia amongst adolescent boys and girls. Consider the following statements in relation to the key interventions being undertaken :
I. It entails supervised weekly administration of 100 mg elemental iron and 500 mu g folic acid.
II. These weekly iron-folic acid supplements are administered by using a fixed day approach.
III. It entails supervised administration of Albendazole 400 mg every three months for control of helminth infestation.
Which of the statements given above is/are correct?

Accepted Answer

I and II

Answer

I only

Answer

I and III

Answer

II only

Question 3

The National Framework for Malaria Elimination in India (2016-2030) has defined certain milestones and targets. Among the following, which is the specific target that has to be met by the year 2027?

Accepted Answer

All states and UTs must reduce API to less than 1 case per 1000 population at risk.

Answer

All states and UTs must establish fully functional malaria surveillance to track, investigate and respond to each case.

Answer

Entire country has to initiate the process for certification of malaria elimination.

Answer

Entire country is to have no indigenous cases and no deaths due to malaria.

Question 4

Under the Pradhan Mantri Surakshit Matritva Abhiyan, the beneficiaries are being provided with a minimum package of antenatal care including certain investigations and drugs on a fixed day of every month. Which day of the month is specified for this purpose?

Accepted Answer

9th day of the month

Answer

1st day of the month

Answer

7th day of the month

Answer

15th day of the month

Question 5

In the most widespread calculation of Stillbirth Rate, the numerator is defined as foetal deaths weighing 'X' grams or more at birth, during the year. Which one of the following is the correct value for 'X'?

Accepted Answer

1000

Answer

750

Answer

1500

Answer

500

Question 6

While performing triage in response to a disaster emergency, commonly an internationally accepted four-colour code system is used. Which one among the following four-colour categories represents the highest priority for emergency response ?

Accepted Answer

Red

Answer

Green

Answer

Black

Answer

Yellow

Question 7

Consider the following statements with regard to Ice-Lined Refrigerator (ILR) employed for storing vaccines at the sub-district level :
I. These types of refrigerators are top-opening.
II. Based on the temperature zone, the inside of ILRs can be divided into 3 parts.
III. The upper part of ILR is cooler compared to the lower part.
IV. Vaccines should never be kept directly on the floor of the ILR as they can get damaged.

Which of the statements given above are correct?

Accepted Answer

II and III

Answer

I and IV

Answer

III and IV

Answer

I and II

Question 8

Which one of the following terms is an "all-or-none phenomenon" and is best described as termination of all transmission of infection by extermination of the infectious agent?

Accepted Answer

Disease eradication

Answer

Disease surveillance

Answer

Disease elimination

Answer

Disease control

Question 9

"Objectives are set forth for different units and subunits, each of which prepares its own plan of action, usually on a short-term basis." The definition best sums up which one among the following terms?

Accepted Answer

Management by objectives

Answer

Input-Output analysis

Answer

Personnel management

Answer

Work sampling

Question 10

In the context of rural healthcare delivery in India, the Panchayati Raj system plays a crucial role in implementing health programs at the grassroots level. Consider the following bodies and their involvement in village-level health initiatives:

I. Gram Sabha - Village health planning and monitoring
II. Gram Panchayat - Implementation of health schemes and sanitation
III. Nyaya Panchayat - Health-related dispute resolution
IV. Panchayat Samiti - Block-level health program coordination

Which of the above bodies are present and actively involved in healthcare delivery at the village level?

Accepted Answer

I and II only

Answer

I, II and III

Answer

III and IV only

Answer

II, III and IV

UPSC-CMS 2025 — Community Medicine