UPSC-CMS 2013 — Community Medicine
23 Previous Year Questions with Answers & Explanations
Universal precautions to be followed by the surgical team include all of the following except :
The amount of previously unrecognized disease that is diagnosed as a result of the screening effort is known as :
The National Health Policy 2002 target to be achieved by the year 2010 is :
Discarded tablets are disposed of in :
In a village of 5,000 population, 50 persons suffered from cholera and 10 persons died. What will be the case fatality ratio?
One of the following diseases has more than one route of transmission :
Serial interval is the gap between :
Vision 2020 India includes all of the following except :
The most sensitive index for surveillance of malaria transmission is :
Apgar score is used in:
UPSC-CMS 2013 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 1: Universal precautions to be followed by the surgical team include all of the following except :
- A. Wearing boots
- B. Wearing double gloves
- C. Donning water repellent gown
- D. Prophylactic antimicrobials (Correct Answer)
Explanation: **Prophylactic antimicrobials** - **Prophylactic antimicrobials** are given to prevent surgical site infections and are not considered a part of **universal precautions** themselves. - Universal precautions are primarily focused on preventing the transmission of bloodborne pathogens through physical barriers. *Wearing boots* - **Wearing boots** or shoe covers is an important component of **universal precautions** in the operating room to protect against splashes and contamination from blood and body fluids. - They also help maintain a sterile environment by preventing the introduction of contaminants from street shoes. *Wearing double gloves* - **Wearing double gloves** offers an extra layer of protection against sharps injuries and potential exposure to blood and body fluids, especially during procedures with a higher risk of puncture. - This practice reinforces the **barrier protection** aspect of universal precautions. *Donning water repellent gown* - A **water-repellent gown** acts as a crucial barrier to protect the surgical team's skin and clothing from contamination with blood, body fluids, and other potentially infectious materials. - This aligns with the principle of **universal precautions** to minimize exposure risks.
Question 2: The amount of previously unrecognized disease that is diagnosed as a result of the screening effort is known as :
- A. Yield (Correct Answer)
- B. Reliability
- C. Predictive accuracy
- D. Validity
Explanation: ***Yield*** - The **yield** of a screening program refers to the amount of **previously unrecognized disease** that is identified through the screening effort. - It essentially measures the **productivity** or **effectiveness** of the screening intervention in detecting new cases. *Reliability* - **Reliability** refers to the **consistency** of a measurement or test, meaning it produces the same results under the same conditions. - It does not describe the amount of new disease found but rather the **reproducibility** of the screening process. *Predictive accuracy* - **Predictive accuracy** (positive predictive value or negative predictive value) indicates the probability that a positive or negative test result **truly reflects** the presence or absence of the disease. - While related to screening performance, it's a measure of how accurately the test predicts disease status, not the overall quantity of newly diagnosed disease. *Validity* - **Validity** refers to the extent to which a test measures what it is intended to measure, encompassing both **sensitivity** and **specificity**. - It describes the **accuracy** of the test in correctly identifying diseased and non-diseased individuals, but not the total number of new cases identified in the population.
Question 3: The National Health Policy 2002 target to be achieved by the year 2010 is :
- A. Reduce infant mortality rate 30/1000 live births (Correct Answer)
- B. Elimination of leprosy
- C. Eradication of polio
- D. Achieve zero level growth of HIV/AIDS
Explanation: ***Reduce infant mortality rate 30/1000 live births*** - The **National Health Policy 2002** specifically set the target of reducing **Infant Mortality Rate (IMR) to 30 per 1000 live births by the year 2010**. - This was one of the key quantifiable goals with a clear timeline aligned with the question's timeframe. - The policy document explicitly mentioned this as a priority target for improving maternal and child health outcomes in India. *Eradication of polio* - While **polio eradication** was indeed a major objective of the National Health Policy 2002, the target year was **2005, not 2010**. - India achieved polio-free status in 2014 when WHO certified the country as polio-free. - This makes it incorrect for the specific year 2010 mentioned in the question. *Elimination of leprosy* - The **elimination of leprosy** (defined as prevalence of less than 1 case per 10,000 population) was targeted for **2005, not 2010**. - India achieved national level elimination in December 2005, though some districts continued to have higher prevalence. - This target predates the 2010 timeline asked in the question. *Achieve zero level growth of HIV/AIDS* - The National Health Policy 2002 aimed to **halt and reverse the HIV/AIDS epidemic** by 2007. - The specific phrase "zero level growth" and the year 2010 do not accurately reflect the policy's stated objectives. - The focus was on stabilizing prevalence and preventing new infections through NACP (National AIDS Control Programme).
Question 4: Discarded tablets are disposed of in :
- A. Yellow plastic bag (Correct Answer)
- B. Black plastic bag
- C. Red plastic bag
- D. Blue plastic bag
Explanation: ***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.
Question 5: In a village of 5,000 population, 50 persons suffered from cholera and 10 persons died. What will be the case fatality ratio?
- A. 0.2%
- B. 5.0%
- C. 20.0% (Correct Answer)
- D. 1.0%
Explanation: ***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.
Question 6: One of the following diseases has more than one route of transmission :
- A. Influenza (Correct Answer)
- B. Leprosy
- C. Cholera
- D. Typhoid fever
Explanation: ***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**.
Question 7: Serial interval is the gap between :
- A. Index and primary case
- B. Primary and secondary case (Correct Answer)
- C. Introduction of infection and development of maximum infectivity
- D. Transmission of infection from patient to another susceptible host
Explanation: ***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.
Question 8: Vision 2020 India includes all of the following except :
- A. Epidemic conjunctivitis (Correct Answer)
- B. Refractive errors
- C. Cataract
- D. Glaucoma
Explanation: ***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**.
Question 9: The most sensitive index for surveillance of malaria transmission is :
- A. Infant parasite rate
- B. Parasite density index
- C. Proportional case rate
- D. Spleen rate (Correct Answer)
Explanation: ***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.
Question 10: Apgar score is used in:
- A. Newborn assessment (Correct Answer)
- B. Maternal health assessment
- C. Nutritional status evaluation
- D. Infectious disease severity grading
Explanation: ***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.