UPSC-CMS 2017 Practice Questions

Q: Consider the following statements regarding folic acid: 1. It is needed for normal development of blood cells in the marrow 2. It has a role in synthesis of nucleic acids 3. It is resistant to boiling Which of the above statements is/are correct?

1 and 2. ***1 and 2*** - **Folic acid** is a crucial coenzyme required for the synthesis of **purines** and **pyrimidines**, which are essential components of **DNA** and **RNA**. - This role in nucleic acid synthesis is vital for cell division and growth, explaining its necessity for the normal development of **blood cells** in the **bone marrow**. *1 and 3* - While folic acid is needed for normal blood cell development, it is generally **not resistant to boiling**. - Folic acid is quite **heat-sensitive** and its content can significantly decrease with cooking, especially prolonged boiling. *1 only* - Folic acid's role extends beyond just blood cell development; its involvement in nucleic acid synthesis is a fundamental biochemical function. - The synthesis of **DNA** and **RNA** is a primary reason why it's essential for rapidly dividing cells, like those in the bone marrow. *2 and 3* - Although folic acid plays a critical role in the synthesis of nucleic acids, it is **not resistant to boiling**. - Its heat-sensitive nature means that cooking methods can significantly impact the availability of **folic acid** in foods.

Q: The maternal and child health care indicator that best reflects the extent of pregnancy wastage as well as the quantity and quality of health care available to the mother and newborn is:

Perinatal Mortality Rate. ***Perinatal Mortality Rate*** - This rate includes both **stillbirths** (fetal deaths after 28 weeks of gestation) and **early neonatal deaths** (deaths within the first seven days of life), encompassing late pregnancy and the immediate post-delivery period. - It reflects the quality of **antenatal care**, **obstetric care**, and **neonatal care**, thus indicating both pregnancy wastage and healthcare quality for mother and newborn. *Infant Mortality Rate* - The **Infant Mortality Rate** measures deaths of children under one year of age, which includes perinatal deaths but also covers a much broader period influenced by factors beyond immediate pregnancy and birth care. - While an important indicator of child health, it is less specific for evaluating issues directly related to **pregnancy wastage** and **delivery care**. *Maternal Mortality Rate* - This rate focuses solely on deaths of women during pregnancy or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management. - It directly reflects the safety of **maternity care** for the mother but does not include outcomes for the newborn or broader pregnancy wastage like stillbirths. *Stillbirth Rate* - The **Stillbirth Rate** specifically measures fetal deaths after 28 weeks (or 20 weeks in some definitions), providing an indicator of deaths in late pregnancy. - While it reflects a significant portion of pregnancy wastage, it does not account for **neonatal deaths** or the quality of care for the live-born infant.

Q: To control Mansonia mosquitoes, the most effective method is:

Removal of water plants. ***Correct: Removal of water plants*** - **Mansonia** mosquitoes have a unique biological adaptation where their **larvae and pupae attach to the roots and stems of aquatic plants** (like *Pistia*, *Eichhornia*, water lettuce) to obtain oxygen through a specialized respiratory siphon - **Removal of aquatic vegetation** is the **most effective control method** because it eliminates the attachment sites essential for larval and pupal respiration - Without host plants, the larvae and pupae cannot obtain oxygen and die, making this the **gold standard** for Mansonia control - This method provides long-term control by eliminating the breeding habitat *Incorrect: Larvicidal insecticides* - While larvicidal insecticides are effective for many mosquito species, they are **less effective for Mansonia** mosquitoes - Since Mansonia larvae remain submerged and attached to plant roots (not coming to the surface for air), conventional larvicides have difficulty reaching them - The larvae's unique oxygen-obtaining mechanism makes them relatively resistant to surface-applied larvicides *Incorrect: Avoidance of water collections* - **Mansonia** mosquitoes breed in large, permanent water bodies with extensive aquatic vegetation (ponds, marshes, swamps) - These are natural habitats that cannot be easily eliminated - Unlike container-breeding mosquitoes (e.g., *Aedes*), avoidance of water collections is impractical and ineffective for Mansonia control *Incorrect: Oiling of water* - **Oiling the water surface** creates a film that prevents mosquito larvae from accessing atmospheric oxygen at the surface - This method works for species like **Anopheles** and **Culex** whose larvae breathe from the water surface - It is **completely ineffective against Mansonia** because their larvae obtain oxygen directly from **aquatic plant roots beneath the surface**, not from atmospheric air

Q: What 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 is often considered a good indicator of the **completed family size** as it projects future fertility based on current patterns. *General Fertility Rate* - The **General Fertility Rate (GFR)** measures the number of live births per 1,000 women of childbearing age (typically 15-49 years) in a given year. - It does not account for the **age structure** within the childbearing population or project completed family size. *Age Specific Fertility Rate* - The **Age Specific Fertility Rate (ASFR)** is the number of births to women in a specific age group per 1,000 women in that age group. - While essential for calculating TFR, ASFR alone describes fertility within a **narrow age band**, not overall completed family size. *Gross Reproduction Rate* - The **Gross Reproduction Rate (GRR)** is similar to the TFR but measures the average number of *daughters* a woman would have. - It is used to estimate the extent to which a generation of women is **replacing itself**, rather than the total number of children.

Q: For a child aged four years, an Anganwadi Worker detects that the weight is lower than expected. What should the Anganwadi Worker do first regarding the malnutrition detected in the child?

Give nutritional counselling to the mother. ***Give nutritional counselling to the mother*** - As an Anganwadi Worker, the **first and most immediate action** for detected malnutrition in a four-year-old child is to provide **nutritional counseling** to the mother. This empowers the caregiver with knowledge and practical advice on improving the child's diet and feeding practices at home. - Counseling can address issues such as **appropriate food choices**, frequency of feeding, overcoming feeding difficulties, and hygiene, which are often at the root of mild to moderate malnutrition. *Refer the child to the nearby Health Centre* - Referring to a health center is essential if the malnutrition is **severe** or if there are **associated medical complications** requiring clinical evaluation and treatment. - However, for initial detection, especially in cases that might be mild, basic nutritional guidance from an Anganwadi Worker is the primary step before escalating to a medical referral. *Start fortnightly deworming* - Deworming is an important public health measure to reduce parasitic load, which can contribute to malnutrition, but it is not the **first and most direct intervention** for managing detected low weight. - While beneficial as part of a comprehensive strategy, deworming alone does not address immediate dietary deficiencies or feeding practices contributing to low weight. *Refer the child a nearby nutritional rehabilitation centre* - Referral to a nutritional rehabilitation center (NRC) is typically reserved for children with **severe acute malnutrition (SAM)** who require intensive, structured feeding and medical management. - For a child whose weight is simply detected as "lower than expected" (which could be moderate or even mild malnutrition), an NRC is usually not the initial or immediate course of action.

Q: Which of the following anthropometrical measurements is/are carried out to assess the growth of children under five years of age? 1. Weight measurement 2. Height measurement 3. Mid upper arm circumference Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Weight, height, and mid-upper arm circumference (MUAC)** are all standard anthropometric measurements used to assess the growth and nutritional status of children under five years of age. - These measurements help identify **underweight, stunted growth, and acute malnutrition** (wasting) in young children. *1 and 2 only* - While **weight and height** are fundamental for growth assessment, excluding MUAC misses a crucial measure for identifying **acute malnutrition**, particularly in community settings. - MUAC is especially valuable for quick screening for **severe acute malnutrition (SAM)**. *1 only* - Measuring only **weight** provides information about overall nutritional status but doesn't differentiate between **wasting (low weight-for-height)** and **stunting (low height-for-age)**, which are distinct growth problems. - **Height** is essential to understand cumulative growth and identify stunting. *2 and 3 only* - Omitting **weight measurement** would significantly hinder a comprehensive assessment of a child's growth and nutritional status. - **Weight** is a primary indicator for tracking growth velocity and identifying both underweight and overweight conditions.

Q: Which of the following statements is/are correct regarding Essential Obstetric Care under the Reproductive, Maternal, Newborn and Child Health care Programme? 1. Early registration of pregnancy 2. Provision of first referral units 3. Provision of safe delivery practices 4. Provision of at least four postnatal checkups Select the correct answer using the code given below:

1, 2, 3 and 4. ***1, 2, 3 and 4*** * Essential Obstetric Care under **RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health)** aims to reduce maternal and neonatal mortality and morbidity. * This comprehensive care package includes early registration of pregnancy, provision of first referral units for complicated cases, promoting safe delivery practices, and ensuring adequate postnatal checkups. *2 and 3 only* * While provision of **first referral units** and **safe delivery practices** are crucial components of Essential Obstetric Care, stating "only" these two is incorrect as other aspects are also fundamental. * Early pregnancy registration and sufficient postnatal care are equally vital for ensuring a healthy mother and child. *1 and 3 only* * **Early registration of pregnancy** and **safe delivery practices** are indeed cornerstones of quality maternal care, but excluding other essential elements like first referral units and postnatal checkups makes this option incomplete. * A holistic approach to essential obstetric care requires all four mentioned components. *1 and 2 only* * **Early registration of pregnancy** and the establishment of **first referral units** are important, but this option incorrectly omits crucial aspects such as safe delivery practices and postnatal care. * Failing to include all essential elements diminishes the effectiveness of the care provided to mothers and newborns.

Q: With reference to quarantine measures to prevent the spread of a disease, which of the following statements is/are correct? 1. In addition to human beings, quarantine measures are at times also applied to an aircraft or a train or a container etc. 2. The duration of the quarantine period is equivalent to the minimum incubation period for the disease Select the correct answer using the code given below:

1 only. **Statement Analysis:** **Statement 1 - CORRECT:** Quarantine measures are indeed applied beyond human beings to various entities including **aircraft, trains, ships, and containers**. This is a standard practice under International Health Regulations (IHR 2005) to prevent the spread of disease vectors or contaminated goods. For example, during outbreaks of vector-borne diseases, aircraft from affected areas may be disinfected, and containers with potentially contaminated goods can be quarantined for inspection. **Statement 2 - INCORRECT:** The duration of quarantine is equivalent to the **maximum incubation period**, NOT the minimum. This is a fundamental principle of quarantine - it must extend through the longest possible incubation period to ensure that anyone exposed will develop symptoms before release. If quarantine were based on the minimum incubation period, individuals infected later in their exposure could still become infectious after being released from quarantine, defeating its purpose. ***Correct Answer: 1 only*** - **Only statement 1 is correct** - quarantine applies to multiple entities beyond humans - **Statement 2 is incorrect** - quarantine duration is based on maximum, not minimum incubation period - This ensures effective disease containment and prevents asymptomatic spread post-quarantine *Incorrect: 2 only* - Statement 2 is fundamentally flawed regarding quarantine duration principles *Incorrect: Both 1 and 2* - While statement 1 is correct, statement 2 contains a critical error about incubation period *Incorrect: Neither 1 nor 2* - Statement 1 is clearly correct as per international health regulations

Q: Which of the following criteria are used for detecting a child with severe acute malnutrition according to WHO guidelines? 1. Bilateral pitting oedema 2. Weight for height Z-score less than minus three SD 3. Mid upper arm circumference of less than 11.5 cm (115 mm) Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - According to **WHO guidelines**, Severe Acute Malnutrition (SAM) in children aged 6-59 months is diagnosed by the presence of **ANY ONE** of these three criteria: - **Bilateral pitting oedema** (nutritional edema) - indicates kwashiorkor - **Weight-for-height Z-score (WHZ) < -3 SD** - indicates severe wasting - **Mid-Upper Arm Circumference (MUAC) < 11.5 cm (115 mm)** - indicates severe wasting - All three are **independent diagnostic criteria** for SAM, meaning any single criterion is sufficient for diagnosis - These criteria are used in **community screening**, **facility-based assessment**, and **nutritional rehabilitation programs** *1 and 2 only* - This incorrectly excludes **MUAC < 11.5 cm**, which is a valid and widely used WHO criterion for SAM diagnosis - MUAC is particularly useful for **community-based screening** as it's simple and doesn't require complex equipment *2 and 3 only* - This incorrectly excludes **bilateral pitting oedema**, which is a critical criterion for diagnosing **kwashiorkor** (edematous malnutrition) - Oedema can occur even when weight-for-height appears normal due to fluid retention masking tissue wasting *1 and 3 only* - This incorrectly excludes **weight-for-height Z-score < -3 SD**, which is the **gold standard anthropometric measure** for severe wasting - WHZ is essential for facility-based diagnosis and monitoring treatment response

Question 1

Consider the following statements regarding folic acid:

1. It is needed for normal development of blood cells in the marrow
2. It has a role in synthesis of nucleic acids
3. It is resistant to boiling Which of the above statements is/are correct?

Accepted Answer

1 and 2

Answer

1 and 3

Answer

1 only

Answer

2 and 3

Question 2

The maternal and child health care indicator that best reflects the extent of pregnancy wastage as well as the quantity and quality of health care available to the mother and newborn is:

Accepted Answer

Perinatal Mortality Rate

Answer

Infant Mortality Rate

Answer

Maternal Mortality Rate

Answer

Stillbirth Rate

Question 3

To control Mansonia mosquitoes, the most effective method is:

Accepted Answer

Removal of water plants

Answer

Avoidance of water collections

Answer

Larvicidal insecticides

Answer

Oiling of water

Question 4

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

Accepted Answer

Total Fertility Rate

Answer

General Fertility Rate

Answer

Age Specific Fertility Rate

Answer

Gross Reproduction Rate

Question 5

For a child aged four years, an Anganwadi Worker detects that the weight is lower than expected. What should the Anganwadi Worker do first regarding the malnutrition detected in the child?

Accepted Answer

Give nutritional counselling to the mother

Answer

Refer the child to the nearby Health Centre

Answer

Start fortnightly deworming

Answer

Refer the child to a nearby nutritional rehabilitation centre

Question 6

Which of the following anthropometrical measurements is/are carried out to assess the growth of children under five years of age?

1. Weight measurement
2. Height measurement
3. Mid upper arm circumference
Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

1 only

Answer

2 and 3 only

Question 7

Which of the following statements is/are correct regarding Essential Obstetric Care under the Reproductive, Maternal, Newborn and Child Health care Programme?

1. Early registration of pregnancy
2. Provision of first referral units
3. Provision of safe delivery practices
4. Provision of at least four postnatal checkups

Select the correct answer using the code given below:

Accepted Answer

1, 2, 3 and 4

Answer

2 and 3 only

Answer

1 and 3 only

Answer

1 and 2 only

Question 8

With reference to quarantine measures to prevent the spread of a disease, which of the following statements is/are correct?

1. In addition to human beings, quarantine measures are at times also applied to an aircraft or a train or a container etc.

2. The duration of the quarantine period is equivalent to the minimum incubation period for the disease

Select the correct answer using the code given below:

Accepted Answer

1 only

Answer

Neither 1 nor 2

Answer

2 only

Answer

Both 1 and 2

Question 9

A pregnant woman visits a medical officer for an antenatal check up. The woman mentions that she had received two doses of Tetanus Toxoid vaccine four years ago. Which of the following steps should the medical officer take with regard to administration of Tetanus Toxoid vaccine as per the Government of India recommended schedule?

Accepted Answer

Two doses of Tetanus Toxoid vaccine should be administered with an interval of four weeks between the two doses

Answer

No Tetanus Toxoid vaccine is required

Answer

Only one dose of Tetanus Toxoid vaccine is required

Answer

Tetanus Immunoglobulin should be administered in the third trimester of pregnancy

Question 10

Which of the following criteria are used for detecting a child with severe acute malnutrition according to WHO guidelines?

1. Bilateral pitting oedema
2. Weight for height Z-score less than minus three SD
3. Mid upper arm circumference of less than 11.5 cm (115 mm)

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

1 and 3 only

Answer

2 and 3 only

UPSC-CMS 2017

Biochemistry

Community Medicine

Obstetrics and Gynecology

Pediatrics