Community Medicine
6 questionsA village has a total of 100 under-five children. The coverage with measles vaccine in these age groups is 60%. Following the occurrence of a measles case in a child after a visit outside, twenty six children developed measles later. The secondary attack rate of measles is :
The method of choice for purification of highly polluted water on a large scale is :
The useful fertility indicator where birth registration statistics do not exist or are inadequate is :
Direct mailing as a means of communication, is an example of:
Mansonioides mosquito transmits the following disease :
Failure rate of contraceptive method is determined by:
UPSC-CMS 2013 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 91: A village has a total of 100 under-five children. The coverage with measles vaccine in these age groups is 60%. Following the occurrence of a measles case in a child after a visit outside, twenty six children developed measles later. The secondary attack rate of measles is :
- A. 66.6% (Correct Answer)
- B. 26.0%
- C. 65.0%
- D. 16.6%
Explanation: ***66.6%*** - The **secondary attack rate** is calculated as (number of secondary cases / number of susceptible contacts exposed to the primary case) × 100. - Total children = 100, with 60% vaccinated (60 children), leaving **40 susceptible children**. - The primary case (one child from the village who visited outside) is part of these 40 susceptible children. - After the primary case occurs, the **remaining susceptible contacts** = 40 - 1 = **39 children**. - Number of secondary cases = 26, so secondary attack rate = (26/39) × 100 = **66.67% ≈ 66.6%**. *65.0%* - This option incorrectly uses all 40 susceptible children as the denominator (26/40 × 100 = 65%). - The error lies in **not excluding the primary case** from the denominator when calculating the secondary attack rate. - The primary case cannot be counted among those "at risk" of secondary infection since they already have the disease. *26.0%* - This represents the **overall attack rate** calculated as (26/100) × 100, using the total population as the denominator. - It fails to account for **vaccination status** and does not represent the secondary attack rate among susceptible contacts. - This is epidemiologically incorrect for measuring disease transmission among susceptibles. *16.6%* - This option appears to use an incorrect denominator, possibly 26/156 or another erroneous calculation. - It does not reflect any standard epidemiological rate calculation for this scenario. - The value is too low to represent the true risk among susceptible contacts.
Question 92: The method of choice for purification of highly polluted water on a large scale is :
- A. Chlorination only
- B. Ultraviolet light treatment
- C. Boiling and chlorination
- D. Super-chlorination followed by de-chlorination (Correct Answer)
Explanation: ***Super-chlorination followed by de-chlorination*** - **Super-chlorination** involves adding a very large dose of chlorine to water to ensure the destruction of all pathogenic microorganisms and removal of organic matter, making it suitable for **highly polluted water**. - **De-chlorination** is then necessary to remove residual chlorine, as high levels can be harmful and impart an unpleasant taste and odor. *Chlorination only* - While effective for disinfection, **chlorination alone** might not be sufficient to purify highly polluted water with significant organic load or diverse pathogens. - Excessive chlorine content without subsequent de-chlorination can lead to **undesirable by-products** and make the water unpalatable. *Ultraviolet light treatment* - **UV light treatment** is an effective disinfectant that inactivates microorganisms, but it does not remove suspended solids, dissolved organic matter, or chemical pollutants often found in **highly polluted water**. - Its efficacy can be reduced by water turbidity, which is common in highly contaminated sources, requiring extensive pre-treatment. *Boiling and chlorination* - **Boiling** is effective for killing most microorganisms but is impractical and energy-intensive for **large-scale water purification**. - **Chlorination** after boiling would still be needed for residual disinfection, but the combination isn't the method of choice for the high volumes typical of municipal water treatment of highly polluted sources.
Question 93: The useful fertility indicator where birth registration statistics do not exist or are inadequate is :
- A. Abortion rate
- B. Child-woman ratio (Correct Answer)
- C. Net reproduction rate
- D. Male-female ratio
Explanation: ***Child-woman ratio*** - The **child-woman ratio** is a common **fertility indicator** used in areas where reliable birth registration data is unavailable. - It calculates the number of **children under 5 years old per 1000 women of childbearing age** (typically 15-49 years), providing an estimate of recent fertility. *Abortion rate* - The **abortion rate** measures the number of abortions per 1,000 women of reproductive age. - While it reflects a component of reproductive behavior, it does not directly measure live births or general fertility and relies on accurate abortion statistics which may also be inadequate. *Net reproduction rate* - The **net reproduction rate (NRR)** is a sophisticated measure that indicates the average number of daughters a woman will have if she survives to the end of her reproductive years, taking into account mortality. - This indicator requires **detailed birth and death statistics by age**, which are precisely what are lacking when birth registration is inadequate. *Male-female ratio* - The **male-female ratio**, or sex ratio, compares the number of males to females in a population. - This ratio is a demographic indicator used to understand population structure but **does not directly measure fertility**.
Question 94: Direct mailing as a means of communication, is an example of:
- A. Individual approach (Correct Answer)
- B. Group approach
- C. Two way communication
- D. Mass approach
Explanation: ***Individual approach*** - Direct mailing involves sending messages to **specific individuals by name and address**, making it a **personalized communication** method. - Each recipient receives an individually addressed communication, allowing for **tailored content** based on recipient characteristics. - It permits **individual follow-up and response**, which is characteristic of individual approach methods in health education. - In Community Medicine classification, direct mail is considered an individual approach because it targets specific persons, not undifferentiated masses. *Mass approach* - Mass approach uses **mass media** (TV, radio, newspapers, billboards) that reach large populations simultaneously without individual targeting. - Mass communication cannot identify or address specific individuals by name. - Direct mailing, despite reaching many people, addresses each person individually, distinguishing it from true mass communication. *Group approach* - Group approach involves communication with **defined small groups** with shared context (group discussions, seminars, demonstrations). - Direct mailing lacks the **interactive, collective experience** characteristic of group communication methods. *Two way communication* - While direct mailing allows for responses, the initial transmission is **one-way**. - However, the individual addressing makes it an individual approach, not defined by its one-way nature.
Question 95: Mansonioides mosquito transmits the following disease :
- A. Dengue
- B. Bancroftian filariasis
- C. Brugian filariasis (Correct Answer)
- D. Malaria
Explanation: ***Brugian filariasis*** - **Mansonioides mosquitoes** are the primary vectors for **Brugian filariasis**, caused by **Brugia malayi** and **Brugia timori**. - This form of filariasis is characterized by **lymphatic obstruction** and **elephantiasis**, predominantly affecting the limbs. *Dengue* - **Dengue** is a viral disease transmitted exclusively by **Aedes mosquitoes**, particularly **Aedes aegypti** and **Aedes albopictus**. - Symptoms include severe fever, headache, retro-orbital pain, muscle and joint pains, and a characteristic skin rash. *Bancroftian filariasis* - **Bancroftian filariasis**, caused by **Wuchereria bancrofti**, is primarily transmitted by **Culex** (e.g., *Culex quinquefasciatus*) and sometimes **Anopheles** or **Aedes mosquitoes**. - While leading to similar lymphatic complications as Brugian filariasis, its vector species differ from Mansonioides. *Malaria* - **Malaria** is transmitted solely by **Anopheles mosquitoes**, which carry the **Plasmodium parasite**. - The disease is characterized by recurring fever, chills, and flu-like symptoms, and can be life-threatening.
Question 96: Failure rate of contraceptive method is determined by:
- A. Total fertility rate
- B. Age specific fertility rate
- C. Pearl index (Correct Answer)
- D. Half life index
Explanation: ***Pearl index*** - The **Pearl index** is a common measure of the effectiveness of a birth control method, indicating the number of accidental pregnancies per 100 women-years of exposure. - A lower Pearl index signifies a **more effective contraceptive method**, meaning fewer pregnancies occur during its use. *Total fertility rate* - The **total fertility rate (TFR)** represents the average number of children born to a woman over her lifetime if she were to experience current age-specific fertility rates. - It reflects overall **population reproduction trends** and not the failure rate of a specific contraceptive method. *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 per year. - This rate provides insights into **fertility patterns across different age brackets** but does not quantify contraceptive effectiveness. *Half life index* - The term **"half-life index"** is not a standard epidemiological or public health measure for contraceptive failure rates. - Half-life usually refers to the **time it takes for a substance to decrease by half** (e.g., drug elimination) or for a radioactive isotope to decay.
Internal Medicine
1 questionsDehydration is not a feature of one of the following diseases :
UPSC-CMS 2013 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 91: Dehydration is not a feature of one of the following diseases :
- A. Cerebral malaria (Correct Answer)
- B. MDR-TB
- C. Pertussis
- D. Cholera
Explanation: ***Cerebral malaria*** - This condition is characterized by neurological symptoms, including **impaired consciousness** and **seizures**, resulting from parasitic infection of the brain. - While patients may have fever and fluid loss from sweating, severe **dehydration is not a primary or defining feature** compared to other diseases listed. *MDR-TB* - Patients with **multidrug-resistant tuberculosis (MDR-TB)** often experience constitutional symptoms such as fever, night sweats, and significant anorexia. - These symptoms can lead to **severe weight loss** and **malnutrition**, contributing to chronic dehydration in advanced stages. *Pertussis* - **Pertussis**, or **whooping cough**, is characterized by severe paroxysmal coughing fits accompanied by inspiratory "whoops" and post-tussive vomiting. - The recurrent vomiting, especially in infants and young children, can quickly lead to **significant fluid loss** and **dehydration**. *Cholera* - **Cholera** is an acute diarrheal illness caused by *Vibrio cholerae*, leading to profuse, watery diarrhea and vomiting [1]. - The rapid and severe fluid loss in cholera can cause **life-threatening dehydration** and electrolyte imbalances within hours if untreated [1].
Pathology
1 questionsAutosomal recessive disorders include all except :
UPSC-CMS 2013 - Pathology UPSC-CMS Practice Questions and MCQs
Question 91: Autosomal recessive disorders include all except :
- A. Hirschsprung disease
- B. Retinoblastoma (Correct Answer)
- C. Albinism
- D. Sickle cell anaemia
Explanation: ***Retinoblastoma*** - Retinoblastoma is the correct answer because it is **NOT an autosomal recessive disorder**. - It follows **autosomal dominant** inheritance in hereditary cases (~40%), where a germline mutation in the RB1 gene is inherited. - Sporadic cases (~60%) result from somatic mutations in both RB1 alleles. - The **two-hit hypothesis** explains tumor development: both copies of the tumor suppressor RB1 gene must be inactivated. *Hirschsprung disease* - Hirschsprung disease has **complex multifactorial inheritance**, not autosomal recessive. - It involves multiple genes (RET, EDNRB, EDN3) with **incomplete penetrance and variable expressivity**. - However, it is not classified as a classic autosomal recessive disorder, making it technically debatable. - Characterized by **absence of ganglion cells** in the distal colon causing functional obstruction. *Albinism* - Oculocutaneous albinism (OCA types 1-4) is a classic **autosomal recessive** disorder [2]. - Results from mutations in genes involved in **melanin biosynthesis** (TYR, OCA2, TYRP1, SLC45A2) [2]. - Leads to reduced or absent pigmentation in skin, hair, and eyes [2]. *Sickle cell anaemia* - Sickle cell anemia is a well-established **autosomal recessive** hemoglobinopathy [1], [3]. - Caused by a point mutation (Glu6Val) in the **HBB gene** encoding beta-globin [3]. - Results in production of hemoglobin S (HbS), causing RBC sickling under hypoxic conditions [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 150-151. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 119-120. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 93-94.
Pediatrics
1 questionsChild starts speaking short sentences by the age of :
UPSC-CMS 2013 - Pediatrics UPSC-CMS Practice Questions and MCQs
Question 91: Child starts speaking short sentences by the age of :
- A. 15 months
- B. 12 months
- C. 24 months (Correct Answer)
- D. 36 months
Explanation: ***24 months*** - By **24 months (2 years old)**, children typically begin to combine two or more words into **short sentences** and use about 50 words or more. - They also start to follow simple instructions and point to named objects and pictures. *15 months* - At **15 months**, children usually say a few words and can point to show what they want, but **short sentences** are not yet typical. They might use gestures more often. - Their vocabulary is still developing and usually consists of single words like "mama" or "dada." *12 months* - At **12 months (1 year old)**, most children are just starting to say their first words and are primarily communicating through gestures and sounds. - They are generally not forming combinations of words into sentences at this stage. *36 months* - By **36 months (3 years old)**, children have more advanced language skills, using **3-4 word sentences**, understanding most of what they hear, and having a vocabulary of several hundred words. - This age represents a more mature stage of language development than the initial formation of short sentences.
Physiology
1 questionsWhich of the following is X-linked dominant trait?
UPSC-CMS 2013 - Physiology UPSC-CMS Practice Questions and MCQs
Question 91: Which of the following is X-linked dominant trait?
- A. Colour blindness
- B. Haemophilia-A
- C. Duchenne muscular dystrophy
- D. Vitamin D resistant rickets (Correct Answer)
Explanation: ***Vitamin D resistant rickets*** - This condition is characterized by **impaired kidney reabsorption of phosphate** and **defective bone mineralization**, leading to rickets, and it is inherited in an **X-linked dominant pattern**. - In X-linked dominant traits, an affected father will pass the trait to **all his daughters**, but none of his sons. An affected mother has a 50% chance of passing the trait to **each child**, regardless of sex. *Colour blindness* - **Color blindness** is an **X-linked recessive** disorder, meaning it is more common in males. - Affected individuals have **difficulty distinguishing certain colors**, usually red and green. *Haemophilia-A* - **Hemophilia A** is an **X-linked recessive** disorder caused by a deficiency in **Factor VIII**, leading to uncontrolled bleeding. - Males are predominantly affected, while females are typically carriers. *Duchenne muscular dystrophy* - **Duchenne muscular dystrophy** is an **X-linked recessive** disorder characterized by progressive muscle degeneration and weakness due to a mutation in the **dystrophin gene**. - It primarily affects males, with symptoms often appearing in early childhood.