UPSC-CMS 2018

119 Questions — Page 4 of 12

All (119)Anatomy (5)Biochemistry (1)Community Medicine (31)ENT (2)Forensic Medicine (1)Internal Medicine (7)Obstetrics and Gynecology (33)Orthopaedics (1)Pathology (1)Pediatrics (5)Pharmacology (4)Physiology (3)Radiology (2)Surgery (23)

Community Medicine

7 questions

Q31

As per biomedical waste management rule 2016 the metallic body implants should be discarded in which of the following?

Q32

Which of the following is NOT a quantitative method in the management of health services?

Q33

The agreement (yes/no) between two observers is statistically measured by:

Q34

How many postnatal visits should be made by the ANM to the house of a low birth weight baby?

Q35

The difference between Type A and Type B sub centre as per Indian Public Health standards is in terms of:

Q36

Which of the following Screening methods for Disease is the least useful?

Q37

Which one of the following is an indicator for evaluation of impact of family planning?

UPSC-CMS 2018 - Community Medicine UPSC-CMS Practice Questions and MCQs

Question 31: As per biomedical waste management rule 2016 the metallic body implants should be discarded in which of the following?

A. Separate collection system (Correct Answer)
B. Red colored non-chlorinated plastic bag
C. Yellow colored non-chlorinated plastic bag
D. Card board box with blue colored marking

Explanation: ***Separate collection system*** - Metallic body implants, due to their nature and potential for **recycling or specific disposal methods**, are to be segregated into a **separate collection system** as per BMW Rule 2016. - This ensures they do not contaminate other biomedical waste streams and can be handled appropriately, often involving **recovery of precious metals**. *Red colored non-chlorinated plastic bag* - This category is typically for **reusable contaminated waste** such as tubing, catheters, IV sets, and urine bags, which are often plastic. - Metallic implants are not typically suitable for disposal in red bags because they are not meant for incineration or autoclaving in the same manner as these plastic items. *Yellow colored non-chlorinated plastic bag* - Yellow bags are used for **human anatomical waste**, animal anatomical waste, soiled waste, expired or discarded medicines, and **chemical waste**. - Metallic implants do not fall into any of these categories and require a different disposal method due to their material composition and potential for recycling. *Card board box with blue colored marking* - Blue or white translucent boxes/containers are designated for **sharps**, including needles, syringes with fixed needles, and blades, as well as broken or contaminated glass. - While metallic, body implants are not considered "sharps" in the same context, nor are they typically discarded in cardboard, which is unsuitable for their weight and specific disposal requirements.

Question 32: Which of the following is NOT a quantitative method in the management of health services?

A. System analysis
B. Network analysis
C. Planning programming budgeting system
D. Management by objectives (Correct Answer)

Explanation: ***Management by objectives*** - **Management by objectives (MBO)** is a strategic management model that aims to improve organizational performance by clearly defining objectives that are agreed upon by both management and employees. - While MBO involves setting **quantifiable goals** and measurable outcomes, the methodology itself is primarily a **qualitative management philosophy** focused on communication, participation, integration, and alignment rather than mathematical modeling or statistical analysis. - Unlike true quantitative methods, MBO does not employ **mathematical algorithms, computational techniques, or statistical modeling** for decision-making—making it the correct answer to this "NOT quantitative" question. *System analysis* - **System analysis** is a quantitative method used to study and optimize complex systems by breaking them down into components to understand their interactions and behavior. - It involves **mathematical modeling, simulation, operations research, and data analysis** to identify bottlenecks, improve efficiency, and make data-driven decisions. *Network analysis* - **Network analysis** is a quantitative technique using mathematical algorithms to model and analyze relationships and flows within a system. - Applications include **project management (PERT/CPM)**, critical path method, resource allocation using computational techniques, and optimization algorithms. *Planning programming budgeting system* - **Planning Programming Budgeting System (PPBS)** is a comprehensive, quantitative approach to government planning and budgeting that links policy planning to resource allocation through numerical analysis. - It involves setting long-term goals, analyzing alternative programs using **cost-effectiveness analysis, benefit-cost ratios**, and allocating resources based on quantitative economic evaluation.

Question 33: The agreement (yes/no) between two observers is statistically measured by:

A. Correlation coefficient
B. Sensitivity
C. Kappa coefficient (Correct Answer)
D. Specificity

Explanation: **Kappa coefficient** - The **kappa coefficient** measures the **inter-rater agreement** for qualitative items, such as a "yes/no" decision, beyond what would be expected by chance. - It takes into account the observed agreement and the agreement expected by chance, providing a more robust measure of agreement than simple percentage agreement. *Correlation coefficient* - The **correlation coefficient** measures the **strength and direction of a linear relationship between two quantitative variables**, not the agreement between two observers on a categorical outcome. - It is used for continuous data and indicates how closely data points fit a linear regression line. *Sensitivity* - **Sensitivity** is a measure of a test's ability to correctly identify individuals who **have a disease (true positive rate)**. - It is not used to assess the agreement between two observers but rather the performance of a diagnostic test against a gold standard. *Specificity* - **Specificity** is a measure of a test's ability to correctly identify individuals who **do not have a disease (true negative rate)**. - Like sensitivity, it evaluates the performance of a diagnostic test and not the consistency of observations between two different raters.

Question 34: How many postnatal visits should be made by the ANM to the house of a low birth weight baby?

A. 8
B. 2
C. 4 (Correct Answer)
D. 6

Explanation: ***4*** - For a **low birth weight (LBW) baby**, as per traditional guidelines, an **Auxiliary Nurse Midwife (ANM)** makes postnatal home visits on **day 1, day 3, day 7, and day 14** after birth = **4 visits**. - This represents the **minimum essential visits** during the critical first two weeks for monitoring growth, feeding, and identifying complications. - **Note**: Current HBNC guidelines recommend at least 6 visits (adding day 28 and 42) for all newborns, with more intensive follow-up for LBW babies. *8* - Eight visits are **not the standard recommendation** for a low birth weight baby's postnatal care by an ANM. - While more frequent follow-ups may be clinically indicated in some complex cases, it is not the general guideline for all LBW babies. *2* - Two postnatal visits are **insufficient** for proper monitoring of a **low birth weight baby**, who is at higher risk for health issues. - This number of visits would miss critical periods for identifying complications or providing essential care. *6* - Six postnatal visits represent the **current HBNC (Home Based Newborn Care) guideline** for all newborns (days 1, 3, 7, 14, 28, 42). - However, the answer key for this UPSC-CMS 2018 question indicates **4 visits** as the expected answer, likely reflecting guidelines at that time.

Question 35: The difference between Type A and Type B sub centre as per Indian Public Health standards is in terms of:

A. Labour room or delivery facility (Correct Answer)
B. Staffing pattern
C. Location
D. Availability of drugs

Explanation: ***Labour room or delivery facility*** - A **Type A Sub-centre** is defined as one where **deliveries are not conducted**, focusing primarily on basic health services, antenatal and postnatal care, and health promotion. - A **Type B Sub-centre** is distinguished by the **provision of delivery services**, requiring specific infrastructure like a labour room and trained personnel to conduct safe deliveries. *Staffing pattern* - While there are specific staffing norms for both types of sub-centres, the fundamental difference between Type A and Type B is not solely based on the general staffing pattern. - The staffing complement in Type B sub-centres is specifically augmented to include personnel capable of assisting with deliveries, which is a consequence of the delivery facility rather than the primary differentiating factor itself. *Location* - The location of a sub-centre (either Type A or Type B) is determined by population norms and geographical accessibility, aiming to serve a defined rural population. - Location itself does not differentiate between Type A and Type B; rather, the services offered at these locations define their type. *Availability of drugs* - Both Type A and Type B sub-centres are expected to maintain a basic stock of essential drugs to provide primary healthcare services to their target population. - The range of drugs might expand in a Type B sub-centre to support delivery services, but the core distinction isn't merely the general availability of drugs.

Question 36: Which of the following Screening methods for Disease is the least useful?

A. Selective screening
B. High risk group screening
C. Mass screening (Correct Answer)
D. Multiphasic screening

Explanation: ***Mass screening*** - Mass screening is the **least useful** screening method when applied indiscriminately to entire unselected populations, particularly for diseases with **low prevalence**. - This approach tests everyone regardless of risk factors, making it highly **resource-intensive** with low efficiency and poor **positive predictive value** for rare conditions. - The high rate of **false positives** leads to unnecessary follow-up investigations, patient anxiety, and wastage of healthcare resources, making it the least cost-effective screening strategy. *Selective screening* - **Selective screening** targets specific high-risk groups or individuals with certain exposures, significantly improving the **yield** and **cost-effectiveness** of the screening program. - This approach focuses resources where the **prevalence of disease** is higher, increasing the likelihood of detecting true cases and reducing false positives compared to mass screening. *High risk group screening* - **High-risk group screening** focuses on individuals with known risk factors, family history, or exposures that significantly increase their likelihood of developing a disease. - This method is highly effective for diseases with clear risk profiles, as it maximizes the **positive predictive value** of the screening test and optimizes resource allocation. *Multiphasic screening* - **Multiphasic screening** involves the simultaneous application of multiple screening tests to detect several conditions at once during a single healthcare encounter. - This approach can be efficient for detecting multiple prevalent diseases in certain populations, offering comprehensive health assessment while being more useful than mass screening due to its targeted nature.

Question 37: Which one of the following is an indicator for evaluation of impact of family planning?

A. Community needs assessment
B. Family size (Correct Answer)
C. Number of postpartum services availed
D. Change in behaviour of people

Explanation: ***Family size*** - This is a true **impact indicator** that measures the long-term effect of family planning programs on demographic outcomes. - A reduction in **average family size** over time directly reflects the program's effectiveness in helping individuals and couples achieve their desired number of children and birth spacing. - Impact indicators measure the ultimate goal of a program, and family size is one of the most important metrics alongside birth rate, fertility rate, and population growth rate. *Community needs assessment* - This is a **planning tool** used to **identify health needs and priorities** of a community, typically conducted *before* implementing a program. - It serves as a baseline for program design rather than an indicator of the *impact* of an already implemented family planning program. - This is part of the initial assessment phase, not an evaluation metric. *Number of postpartum services availed* - This is an **output/utilization indicator** that measures **service delivery** rather than program impact. - While important for monitoring service uptake, it does not directly evaluate the overall impact or effectiveness of family planning on birth rates or family size decisions. - Output indicators measure what was done, not the effect achieved. *Change in behaviour of people* - While behavioral changes (e.g., increased contraceptive use) are important, this option is too **broad and vague** to serve as a specific measurable indicator. - This could be considered a **process or intermediate outcome indicator** but is not a direct measure of program impact. - Changes in family size are a more concrete and quantifiable outcome reflecting the combined effect of behavioral changes.

Obstetrics and Gynecology

1 questions

Q31

Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Pediatrics

1 questions

Q31

When should breastfeeding be initiated to an infant born via a normal delivery?

Physiology

1 questions

Q31

Consider the following hemodynamic changes occurring during pregnancy: 1. Increase in cardiac output 2. Increase in stroke volume 3. Increase in colloid oncotic pressure 4. Increase in pulse rate Which of the statements given above are correct?