Community Medicine
5 questionsThe net reproduction rate of 1 is primarily determined by which of the following demographic rates?
According to the WHO guidelines, the Body Mass Index cut off for overweight is:
Horrock's apparatus is used to measure :
The order of priority of immunization strategy to prevent congenital rubella infection from first to last is :
Diethyltoluamide is an effective :
UPSC-CMS 2013 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 101: The net reproduction rate of 1 is primarily determined by which of the following demographic rates?
- A. Couple protection rate
- B. Total marital fertility rate
- C. Age specific marital fertility rate
- D. Total fertility rate (Correct Answer)
Explanation: ***Total fertility rate*** - The **Net Reproduction Rate (NRR)** is a refinement of the **Gross Reproduction Rate (GRR)**, which itself is derived from the **Total Fertility Rate (TFR)**. - An NRR of 1 implies that a generation of women is exactly replacing itself, meaning that, on average, each woman is giving birth to enough daughters who survive to reproductive age to take her place. This is directly linked to the overall fertility level represented by the Total Fertility Rate. *Couple protection rate* - The **couple protection rate** measures the percentage of eligible couples effectively protected against conception, typically through family planning methods. - While it influences the **Total Fertility Rate**, it is not the primary determinant of the **Net Reproduction Rate** itself. *Total marital fertility rate* - The **total marital fertility rate** measures the average number of children born to a woman within marriage. - It does not account for births outside of marriage or for the mortality of women before or during their reproductive years, which are crucial components of the **Net Reproduction Rate**. *Age specific marital fertility rate* - The **age-specific marital fertility rate** measures the number of births to married women within a specific age group. - This is a more granular component of fertility measurement but not the primary determinant of the overall replacement level indicated by an **NRR of 1**, which requires a broader measure like the **Total Fertility Rate**.
Question 102: According to the WHO guidelines, the Body Mass Index cut off for overweight is:
- A. ≥ 25 (Correct Answer)
- B. ≥ 18
- C. ≥ 35
- D. ≥ 30
Explanation: ***≥ 25*** - A **Body Mass Index (BMI)** of **25.0 to 29.9 kg/m²** is classified as **overweight** according to **WHO international guidelines**. - This classification indicates a higher risk of developing various health problems. - **Note:** For Asian populations including India, modified cutoffs are used where **overweight is ≥23 kg/m²**. *≥ 18* - A BMI of **less than 18.5 kg/m²** is classified as **underweight**, indicating potential nutritional deficiencies. - A BMI between **18.5 and 24.9 kg/m²** is considered **normal weight** per WHO standards. *≥ 35* - A BMI of **≥ 35 kg/m²** falls into the category of **Obesity Class II or III**, representing a severe level of obesity. - This signifies a significantly elevated risk for severe health complications. *≥ 30* - A BMI of **≥ 30 kg/m²** is classified as **obese**, specifically **Obesity Class I**. - This threshold indicates a clear need for weight management interventions to reduce health risks.
Question 103: Horrock's apparatus is used to measure :
- A. Free and combined chlorine
- B. Chlorine demand
- C. Free chlorine (Correct Answer)
- D. Combined chlorine
Explanation: ***Free chlorine*** - Horrock's apparatus is a device specifically designed for the **estimation of residual free chlorine** in treated water. - It uses a tablet and a comparator system to visually match the color produced with a standard scale, indicating the free chlorine level. *Free and combined chlorine* - This apparatus is specifically designed for **free chlorine** and does not directly measure combined chlorine. - While total chlorine (free + combined) can be inferred through subsequent tests, the Horrock's apparatus itself isolates free chlorine. *Chlorine demand* - **Chlorine demand** refers to the amount of chlorine used up by impurities in water before a residual begins to form, and is not directly measured by Horrock's apparatus. - It is determined by knowing the added chlorine dose and the residual chlorine remaining after a contact period. *Combined chlorine* - **Combined chlorine** refers to chlorine that has reacted with ammonia or organic nitrogen compounds, forming chloramines, and is not the primary measurement of Horrock's apparatus. - Measuring combined chlorine typically involves different methods or calculations after determining free and total chlorine.
Question 104: The order of priority of immunization strategy to prevent congenital rubella infection from first to last is :
- A. Women of reproductive age group → children 1-14 years → Infants
- B. Infants → women of reproductive age group → children 1-14 years
- C. Women of reproductive age group → Infants → children 1-14 years
- D. Infants → children 1-14 years → women of reproductive age group (Correct Answer)
Explanation: ***Infants → children 1-14 years → women of reproductive age group*** - **Infants first**: Establishing **routine infant immunization** (MR/MMR vaccine) is the cornerstone of sustainable rubella control and prevention of congenital rubella syndrome (CRS). - **Children 1-14 years**: Conducting **catch-up campaigns** in this age group rapidly builds **herd immunity** and interrupts rubella virus circulation in the community. - **Women of reproductive age**: Supplementary vaccination of susceptible women provides additional protection but should only be implemented **after** establishing routine infant immunization to avoid the **"honeymoon period" paradox**. - This sequence follows **WHO-recommended rubella immunization strategy** for achieving CRS elimination while maintaining long-term sustainability. *Women of reproductive age group → children 1-14 years → Infants* - Prioritizing women first without establishing routine infant immunization is **not sustainable** and can paradoxically increase CRS risk in the long term. - This approach fails to interrupt viral transmission and leaves future generations vulnerable once selective vaccination campaigns end. *Infants → women of reproductive age group → children 1-14 years* - While starting with infants is correct, vaccinating women before the 1-14 year age group is **less efficient** for rapidly building herd immunity. - Children aged 1-14 years are the **primary drivers of rubella transmission** in communities and should be prioritized for catch-up campaigns. *Women of reproductive age group → Infants → children 1-14 years* - This sequence incorrectly places women first and delays vaccination of the 1-14 year age group, who are **critical for establishing herd immunity**. - Without addressing the major reservoir of infection (older children), pregnant women remain at risk from community transmission.
Question 105: Diethyltoluamide is an effective :
- A. Agent against propagation of Anopheles
- B. Space spray
- C. Repellent (Correct Answer)
- D. Larvicide
Explanation: ***Repellent*** - **Diethyltoluamide (DEET)** is a highly effective and widely used **insect repellent**. - It works by creating an olfactory barrier that deters mosquitoes and other biting insects. *Agent against propagation of Anopheles* - While DEET can prevent bites from **Anopheles mosquitoes**, it doesn't directly target their reproduction or population growth. - Measures against propagation typically involve **larvicides**, habitat modification, or insecticidal spraying. *Space spray* - **Space sprays** are designed to kill insects in an area, often using insecticides like pyrethroids, rather than repelling them from an individual. - DEET's mechanism is to deter insects from landing on skin or clothing, not to kill them in an open space. *Larvicide* - **Larvicides** are chemical or biological agents used to kill insect larvae, particularly mosquito larvae, in aquatic breeding sites. - DEET is applied to the skin or clothing to prevent adult insect bites and does not act on larvae.
Obstetrics and Gynecology
1 questionsAmong the causes of maternal mortality, which of the following is correct in descending order of maternal deaths in India ?
UPSC-CMS 2013 - Obstetrics and Gynecology UPSC-CMS Practice Questions and MCQs
Question 101: Among the causes of maternal mortality, which of the following is correct in descending order of maternal deaths in India ?
- A. Obstructed labour, haemorrhage, abortion, sepsis
- B. Haemorrhage, sepsis, abortion, obstructed labour (Correct Answer)
- C. Haemorrhage, obstructed labour, abortion, sepsis
- D. Sepsis, obstructed labour, abortion, haemorrhage
Explanation: ***Haemorrhage, sepsis, abortion, obstructed labour*** - This order reflects the **leading causes of maternal mortality in India** as per data available during 2010-2013 period. - **Haemorrhage** (38%) is the primary cause due to postpartum hemorrhage, antepartum bleeding, and complications during delivery. - **Sepsis** (11%) includes puerperal sepsis and infections following unsafe deliveries. - **Abortion** (8%) complications, particularly from unsafe procedures, remain a significant contributor. - **Obstructed labour** causes have decreased with improved access to cesarean sections and skilled birth attendance. *Obstructed labour, haemorrhage, abortion, sepsis* - This order is incorrect as **haemorrhage** consistently ranks as the leading cause of maternal deaths in India, not obstructed labour. - Obstructed labour has significantly declined due to better access to emergency obstetric care. *Haemorrhage, obstructed labour, abortion, sepsis* - This order is incorrect because **sepsis** accounts for a higher percentage of maternal deaths than obstructed labour. - While haemorrhage is correctly placed first, sepsis should come before obstructed labour in the ranking. *Sepsis, obstructed labour, abortion, haemorrhage* - This order is completely incorrect as **haemorrhage** is overwhelmingly the leading cause of maternal mortality in India. - Placing haemorrhage last contradicts all epidemiological data on maternal deaths in India.
Pharmacology
1 questionsWhich of the following is an absolute contraindication for combined contraceptive oral pills ?
UPSC-CMS 2013 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following is an absolute contraindication for combined contraceptive oral pills ?
- A. Migraine without aura
- B. Previous history of thrombo-embolism (Correct Answer)
- C. Diabetes mellitus
- D. Gall bladder disease
Explanation: ***Previous history of thrombo-embolism*** - A history of **thromboembolism** significantly increases the risk of recurrent events with combined oral contraceptive pills (COCs) due to their procoagulant effects [1, 2]. - COCs contain **estrogen**, which can enhance the synthesis of clotting factors and decrease natural anticoagulants, making them absolutely contraindicated in this setting [1]. *Migraine without aura* - **Migraine without aura** is generally considered a relative contraindication or a condition requiring careful consideration, not an absolute contraindication, for combined oral contraceptive pills. - The risk of **stroke** is slightly elevated in women with migraine without aura using COCs, but it is not as high as with migraine with aura. *Diabetes mellitus* - **Diabetes mellitus** itself is not an absolute contraindication for combined oral contraceptive pills, especially if it is well-controlled and there are no vascular complications. - However, in cases of diabetes with **vascular complications** (e.g., nephropathy, retinopathy, neuropathy) or of >20 years' duration, COCs are generally contraindicated. *Gall bladder disease* - While combined oral contraceptive pills can increase the risk of **gallstone formation**, especially in susceptible individuals, it is not considered an absolute contraindication. - The effect is linked to **estrogen-induced changes** in bile composition, but careful monitoring is usually sufficient rather than absolute avoidance.
Psychiatry
1 questionsThe attitude is a domain of:
UPSC-CMS 2013 - Psychiatry UPSC-CMS Practice Questions and MCQs
Question 101: The attitude is a domain of:
- A. affective learning (Correct Answer)
- B. psychomotor learning
- C. cognitive learning
- D. temporal learning
Explanation: ***affective learning*** - The **affective domain of learning** deals with how we perceive, value, and feel about things, encompassing emotions, attitudes, values, and motivations. - Developing a particular **attitude** involves changes in feelings and emotions towards a subject or person, aligning directly with the objectives of affective learning. *psychomotor learning* - **Psychomotor learning** focuses on the development of physical skills and coordinated movements. - It involves the acquisition of **manipulative skills** and performance of actions, which is distinct from internal attitudes. *cognitive learning* - **Cognitive learning** primarily involves mental processes such as knowledge, comprehension, application, analysis, synthesis, and evaluation. - This domain relates to the acquisition and understanding of **factual information** and intellectual skills, not attitudes. *temporal learning* - **Temporal learning** is not a recognized standalone domain of learning in Bloom's Taxonomy or similar educational frameworks. - While learning often occurs over time, the term "temporal learning" doesn't describe a specific focus like attitudes, skills, or knowledge.