UPSC-CMS 2010 - Community Medicine Practice Questions

Q: Consider the following strategies pertaining to National Anti-Malaria Programme: 1. Early case detection and prompt treatment with ACT (Artemisinin Combination Therapy) 2. Indoor Residual Spraying (IRS) in areas with API ≥2 3. Distribution and promotion of Long Lasting Insecticidal Nets (LLINs) Which of the above strategies is/are being used in India?

1, 2 and 3. ***1, 2 and 3*** - The **National Anti-Malaria Programme (NAMP)** in India utilizes all three strategies as core components for malaria control and elimination. - **Early case detection and prompt treatment with ACT** are crucial for reducing the parasite reservoir and preventing severe disease. **Indoor Residual Spraying (IRS)** is used for vector control, especially in high-burden areas (API ≥2), and **Long Lasting Insecticidal Nets (LLINs)** provide personal protection against mosquito bites. *2 and 3 only* - This option is incorrect because it excludes **early case detection and prompt treatment with ACT**, which is a fundamental and critical strategy in malaria control. - Effective **case management** is essential for reducing transmission and morbidity/mortality, alongside vector control methods like IRS and LLINs. *1 and 2 only* - This option is incorrect as it omits the **distribution and promotion of Long Lasting Insecticidal Nets (LLINs)**, which are a highly effective and widely implemented tool for preventing mosquito bites and reducing malaria transmission, particularly in endemic areas. - **LLINs** are a cost-effective intervention promoting personal protection, empowering communities in malaria prevention efforts. *1 only* - This option is incorrect because relying solely on **early case detection and prompt treatment** is insufficient for comprehensive malaria control. - Effective malaria control requires a multi-pronged approach that also incorporates **vector control strategies** like IRS and LLINs to reduce human-vector contact.

Q: Which is the correct sequence in increasing order for crude birthrates in the countries named herewith?

Japan, Sri Lanka, India, Nepal. ***Japan, Sri Lanka, India, Nepal*** - This sequence correctly orders the given countries from the lowest to the highest **crude birth rate**. - Japan consistently has one of the lowest birth rates globally due to an aging population and socio-economic factors. Sri Lanka and India follow with moderate birth rates, while Nepal generally has a higher birth rate compared to the others, influenced by factors like rural populations and access to healthcare. *India, Japan, Sri Lanka, Nepal* - This option incorrectly places **India first**, when its birth rate is significantly higher than Japan's and Sri Lanka's. - **Japan's birth rate** is notably lower than India's and Sri Lanka's, making this sequence incorrect. *India, Japan, Nepal, Sri Lanka* - This sequence is incorrect as it places **India first** and has an incorrect relative order between Nepal and Sri Lanka compared to their actual birth rates. - **Japan's birth rate** is the lowest among these countries, so it should be at the beginning of an increasing order, not after India. *Sri Lanka, Japan, Nepal, India* - This option incorrectly places **Sri Lanka first** and misrepresents the relative positions of Japan, Nepal, and India in terms of birth rates. - **Japan has the lowest birth rate** among the listed countries, so it should precede Sri Lanka in an increasing order.

Q: Which is the fertility indicator that gives the approximate magnitude of completed family size?

Total Fertility Rate. ***Total Fertility Rate*** - The **Total Fertility Rate (TFR)** estimates the average number of children a woman would have over her lifetime if she were to experience current age-specific fertility rates. - It provides a measure of the **completed family size** in a hypothetical cohort of women. *Age-specific Fertility Rate* - The **Age-specific Fertility Rate (ASFR)** measures the number of births to women in a particular age group per 1,000 women in that age group. - It does not directly provide the completed family size but is a component used to calculate the TFR. *General Fertility Rate* - The **General Fertility Rate (GFR)** calculates the number of live births per 1,000 women of childbearing age (typically 15-49 years) in a given year. - While it reflects overall fertility, it does not provide an estimate of the completed family size per woman. *Gross Reproduction Rate* - The **Gross Reproduction Rate (GRR)** is similar to the TFR but only considers female births. - It estimates the average number of daughters a woman would have over her lifetime based on current age-specific fertility rates, without accounting for mortality.

Q: Consider the following demographic parameters : 1. Average number of daughters born to a woman 2. Sum of age-specific fertility rates 3. Magnitude of completed family size Which of the above parameters reflect/reflects total fertility rate?

2 and 3. ***2 and 3*** - The **total fertility rate (TFR)** is precisely defined as the **sum of age-specific fertility rates (ASFR)** across all reproductive age groups (15-49 years), representing the average number of children a woman would bear if she experienced current age-specific fertility rates throughout her reproductive life. - TFR conceptually indicates the **magnitude of completed family size** under current fertility conditions, though technically TFR is a period (synthetic cohort) measure while completed family size is an observed cohort measure. - Parameter 2 is the **direct definition**, while parameter 3 represents the **conceptual interpretation** of what TFR indicates. *1 only* - The "average number of daughters born to a woman" represents the **Gross Reproduction Rate (GRR)**, not TFR. - GRR = TFR × proportion of female births (approximately 0.49). - **TFR includes all live births** regardless of sex, making this parameter incorrect for TFR. *1 and 3* - Parameter 1 represents GRR, not TFR, making this combination incorrect. - Including an incorrect parameter invalidates this option despite parameter 3 having conceptual relevance. *3 only* - While completed family size has conceptual relationship to TFR, this option omits parameter 2, which is the **primary and precise definition** of TFR. - TFR is calculated as the sum of ASFRs, not measured from actual completed families, making this incomplete.

Q: The larvae of which one of the following mosquitoes cannot successfully be killed by spreading oil on the surface of its breeding water sources?

Mansonoides. ***Mansonoides*** - The larvae of *Mansonoides* mosquitoes attach to the underwater stems and roots of **aquatic vegetation** for oxygen. - This adaptation means they do not surface to breathe, rendering **surface oiling ineffective** against them. *Aedes* - *Aedes* larvae are **surface breathers**, obtaining oxygen from the air-water interface. - Oiling the water surface forms a film that **prevents oxygen uptake**, suffocating the larvae. *Culex* - *Culex* larvae are also **surface breathers** and, like *Aedes*, rely on the air-water interface for oxygen. - An oil film on the water surface will **block their access to atmospheric oxygen**, leading to their demise. *Anopheles* - *Anopheles* larvae are **surface dwellers** that lie parallel to the water surface, using their **spiracles** to breathe air. - An oil layer effectively **obstructs these spiracles**, preventing respiration and killing the larvae.

Q: Match List-I with List-II and select the correct answer using the code given below the Lists: List-I (Vectors): A. Hard ticks B. Sandflies C. Louse D. Soft ticks List-II (Diseases): 1. Oriental sore 2. Epidemic typhus 3. Tularemia 4. Relapsing fever

A→3 B→1 C→2 D→4. ***A→3 B→1 C→2 D→4*** - **Hard ticks** (A) are primary vectors for **tularemia** (3), transmitting *Francisella tularensis* through their bite during blood feeding. - **Sandflies** (B) transmit **oriental sore** (1), the cutaneous form of **leishmaniasis** caused by *Leishmania tropica* and other species. *A→4 B→1 C→3 D→2* - Incorrectly matches **hard ticks** with **relapsing fever**, which is specifically transmitted by **soft ticks** (*Ornithodoros* species). - Misassociates **louse** with **tularemia**, when **body lice** are established vectors for **epidemic typhus**. *A→1 B→2 C→3 D→4* - Wrongly pairs **hard ticks** with **oriental sore**, which requires **sandfly** vectors for transmission of *Leishmania* parasites. - Incorrectly matches **sandflies** with **epidemic typhus**, a louse-borne disease caused by *Rickettsia prowazekii*. *A→2 B→4 C→1 D→3* - Mismatches **hard ticks** with **epidemic typhus**, which is transmitted by **body lice**, not tick species. - Incorrectly associates **soft ticks** with **tularemia**, when they are specific vectors for **relapsing fever** caused by *Borrelia* species.

Question 1

Consider the following strategies pertaining to National Anti-Malaria Programme:

1. Early case detection and prompt treatment with ACT (Artemisinin Combination Therapy)

2. Indoor Residual Spraying (IRS) in areas with API ≥2

3. Distribution and promotion of Long Lasting Insecticidal Nets (LLINs)

Which of the above strategies is/are being used in India?

Accepted Answer

1, 2 and 3

Answer

2 and 3 only

Answer

1 and 2 only

Answer

1 only

Question 2

Which is the correct sequence in increasing order for crude birthrates in the countries named herewith?

Accepted Answer

Japan, Sri Lanka, India, Nepal

Answer

India, Japan, Sri Lanka, Nepal

Answer

India, Japan, Nepal, Sri Lanka

Answer

Sri Lanka, Japan, Nepal, India

Question 3

Which is the fertility indicator that gives the approximate magnitude of completed family size?

Accepted Answer

Total Fertility Rate

Answer

Age-specific Fertility Rate

Answer

General Fertility Rate

Answer

Gross Reproduction Rate

Question 4

Consider the following demographic parameters :

1. Average number of daughters born to a woman

2. Sum of age-specific fertility rates

3. Magnitude of completed family size
Which of the above parameters reflect/reflects total fertility rate?

Accepted Answer

2 and 3

Answer

1 only

Answer

1 and 3

Answer

3 only

Question 5

The larvae of which one of the following mosquitoes cannot successfully be killed by spreading oil on the surface of its breeding water sources?

Accepted Answer

Mansonoides

Answer

Aedes

Answer

Culex

Answer

Anopheles

Question 6

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

List-I (Vectors):
A. Hard ticks
B. Sandflies
C. Louse
D. Soft ticks

List-II (Diseases):
1. Oriental sore
2. Epidemic typhus
3. Tularemia
4. Relapsing fever

Accepted Answer

A→3  B→1  C→2  D→4

Answer

A→4  B→1  C→3  D→2

Answer

A→1  B→2  C→3  D→4

Answer

A→2  B→4  C→1  D→3

UPSC-CMS 2010 — Community Medicine