UPSC-CMS 2019 - Community Medicine PYQs Practice Questions

Q: Global hunger index combines four indicators EXCEPT:

Child morbidity. ***Child morbidity*** - **Child morbidity** is not used as an indicator in the Global Hunger Index. While related to health outcomes, the GHI focuses on specific measures of **undernutrition** and **child mortality**. - Morbidity refers to the prevalence of disease, which is a broader health measure and not specific to hunger assessment within the GHI framework. *Child stunting* - **Child stunting** is a key indicator in the GHI, measuring the proportion of children under the age of five who have low **height-for-age**. - This indicator reflects **chronic undernutrition** and its long-term impact on children's growth and development. - Stunting indicates inadequate nutrition over an extended period. *Child mortality* - **Child mortality** is included in the GHI and represents the mortality rate of children under the age of five. - This indicator reflects the fatal synergy between **inadequate nutrition** and unhealthy environments on young children. - It captures the ultimate consequence of food insecurity and undernutrition. *Undernourishment* - **Undernourishment** is one of the primary indicators in the GHI, measuring the proportion of the population whose **caloric intake is insufficient** to meet dietary energy requirements. - This indicator directly reflects the **food supply situation** and adequacy of dietary energy consumption at the population level. [Practice more Community Medicine PYQs on OnCourse]

Q: Physical Quality of life consolidates which of the following indicators? 1. Infant Mortality Rate 2. Life expectancy at birth 3. Literacy 4. Per capita income 5. Mean years of schooling 6. Life expectancy at age one Select the correct answer using the code given below:

1, 3 and 6. ***1, 3 and 6*** - The **Physical Quality of Life Index (PQLI)** comprises **infant mortality rate**, **life expectancy at age one**, and **literacy rate**. - These indicators were selected to reflect basic human needs and well-being, independent of purely economic measures. *1, 2 and 3* - While **infant mortality rate** and **literacy** are part of PQLI, **life expectancy at birth** is not one of its three core components. - PQLI specifically uses **life expectancy at age one** to avoid the significant influence of high infant mortality on overall life expectancy at birth. *2, 3 and 6* - **Life expectancy at age one** and **literacy** are included in PQLI, but **life expectancy at birth** is not. - The PQLI's design intentionally focuses on outcomes after the critical first year of life. *1, 4 and 5* - **Infant mortality rate** is a PQLI component, but **per capita income** and **mean years of schooling** are not. - **Per capita income** is an economic indicator and explicitly excluded from PQLI, while **mean years of schooling** is more commonly associated with the Human Development Index (HDI). [Practice more Community Medicine PYQs on OnCourse]

Q: The sequence of events leading to disability and handicap is:

Disease → Impairment→Disability→Handicap. ***Disease → Impairment→Disability→Handicap*** - This sequence follows the **WHO International Classification of Impairments, Disabilities, and Handicaps (ICIDH, 1980)** model, which correctly illustrates the progression from a health condition to its societal consequences. - A **disease** or health condition leads to **impairment** (loss or abnormality of body structure/function), which then restricts activities (**disability**), and ultimately impacts social roles (**handicap**). *Disease → Disability→Impairment→Handicap* - This order is incorrect because **impairment** (a problem in body function or structure) logically precedes **disability** (a difficulty executing tasks). - **Disability** arises from the *functional limitation* caused by impairment, not the other way around. *Disease → Disability→Handicap→Impairment* - This sequence is incorrect as **impairment** is the initial consequence of disease on a functional level, occurring before **disability** and **handicap**. - **Handicap** represents the societal and environmental disadvantage, which is the final stage in this classic WHO model. *Disease → Handicap→Impairment→Disability* - This order is incorrect because **handicap**, which refers to a social disadvantage, is the last step in the disablement process, following impairment and disability. - **Impairment** is a direct result of the disease, and **disability** follows from that impairment. [Practice more Community Medicine PYQs on OnCourse]

Q: Which one of the following statements is NOT true for taking a decision on screening for disease?

Proportion of false negatives is high. ***Proportion of false negatives is high*** - A **high proportion of false negatives** means that many individuals with the disease are missed by the screening test. - This is **absolutely undesirable** for screening and directly contradicts the fundamental principle that screening tests should have **high sensitivity**. - This statement is clearly NOT true as a criterion for making screening decisions. *Sensitivity and specificity are high* - **High sensitivity** means the test correctly identifies most people who have the disease, minimizing false negatives. - **High specificity** means the test correctly identifies most people who do not have the disease, minimizing false positives. - Both are desirable characteristics according to Wilson-Jungner screening criteria. *Disease prevalence should be high* - This statement is **oversimplified and not strictly accurate** according to Wilson-Jungner criteria. - The actual criterion is: **"The condition should be an important health problem"** - based on disease burden, severity, and consequences, NOT necessarily high prevalence. - Many successful screening programs target **low prevalence diseases** (e.g., phenylketonuria in newborns, congenital hypothyroidism). - What matters is the **positive predictive value (PPV)** and cost-effectiveness, which are influenced by prevalence but don't require "high" prevalence. *Disease is lethal* - The Wilson-Jungner criterion states the disease should have **"serious consequences if left untreated"** - this includes but is not limited to lethality. - Screening is justified for diseases causing **significant morbidity or mortality** where early detection improves outcomes. - The disease should be sufficiently serious to warrant the costs and potential harms of screening. [Practice more Community Medicine PYQs on OnCourse]

Q: In a case-control study, 300 women aged 20-45 years suffering from breast cancer were compared with age-matched 300 women without breast cancer. It was observed that 120 women among cases and 60 women among controls were obese. The odds ratio of developing breast cancer among obese women is:

8/3. **8/3** - The **odds ratio** is calculated using the formula (a×d) / (b×c) from a 2×2 contingency table. - Setting up the table: Cases (breast cancer) vs Controls (no breast cancer) by exposure (obesity status) - a = obese cases = 120 - b = obese controls = 60 - c = non-obese cases = 300 - 120 = 180 - d = non-obese controls = 300 - 60 = 240 - **Odds ratio = (120 × 240) / (60 × 180) = 28,800 / 10,800 = 8/3** - This indicates that **obese women have 2.67 times the odds** of developing breast cancer compared to non-obese women. *11/5* - This answer suggests an **incorrect calculation** of the odds ratio, likely due to misassignment of values in the 2×2 table or an arithmetic error. - The result (2.2) does not match the correct cross-product ratio from the given data. *11/3* - This value is not derived from the correct **odds ratio** calculation using the given data. - Errors in setting up the 2×2 table or confusing which cells represent **exposed cases**, **exposed controls**, **unexposed cases**, and **unexposed controls** lead to such incorrect results. *9/5* - This option would result from an **incorrect placement** of values when calculating the cross-product ratio. - Possibly from reversing the numerator and denominator components or miscalculating the unexposed groups. [Practice more Community Medicine PYQs on OnCourse]

Question 1

Global hunger index combines four indicators EXCEPT:

Accepted Answer

Child morbidity

Answer

Child stunting

Answer

Child mortality

Answer

Undernourishment

Question 2

Physical Quality of life consolidates which of the following indicators?

1. Infant Mortality Rate
2. Life expectancy at birth
3. Literacy
4. Per capita income
5. Mean years of schooling
6. Life expectancy at age one

Select the correct answer using the code given below:

Accepted Answer

1, 3 and 6

Answer

1, 2 and 3

Answer

2, 3 and 6

Answer

1, 4 and 5

Question 3

The sequence of events leading to disability and handicap is:

Accepted Answer

Disease → Impairment→Disability→Handicap

Answer

Disease → Disability→Impairment→Handicap

Answer

Disease → Disability→Handicap→Impairment

Answer

Disease → Handicap→Impairment→Disability

Question 4

Which one of the following statements is NOT true for taking a decision on screening for disease?

Accepted Answer

Proportion of false negatives is high

Answer

Sensitivity and specificity are high

Answer

Disease prevalence should be high

Answer

Disease is lethal

Question 5

In a case-control study, 300 women aged 20-45 years suffering from breast cancer were compared with age-matched 300 women without breast cancer. It was observed that 120 women among cases and 60 women among controls were obese. The odds ratio of developing breast cancer among obese women is:

Accepted Answer

8/3

Answer

11/5

Answer

11/3

Answer

9/5

Question 6

Standardized Mortality ratio is best explained by which one of the following statements?

Accepted Answer

Ratio of observed number of deaths to the expected number of deaths in a population

Answer

New spells of disease in a given period of time per 1000 population

Answer

Number of deaths in a given period of time per 1000 population

Answer

Percentage of deaths in women as compared to deaths in men

Question 7

In a family of six (2 parents and 4 children), the youngest child catches measles infection. The parents are immune to the infection. On 3rd and 5th day of the infection of the first child, the two other children also suffer from measles. The secondary attack rate (SAR) of measles is:

Accepted Answer

66.6 %

Answer

40 %

Answer

50 %

Answer

33.3 %

Question 8

What is the relative risk of developing pulmonary embolism in users of oral contraceptives as per the information given below?

Accepted Answer

4.80

Answer

0.24

Answer

0.48

Answer

2.40

Question 9

Which one of the following epidemiologic methods can be used to identify risk factors and estimate the degree of risk?

Accepted Answer

Case control and Cohort studies

Answer

Cohort study and Ecological studies

Answer

Case control and Cross-sectional studies

Answer

Cohort study and Randomized controlled trial

Question 10

Which one of the following tests should be applied to compare mean haemoglobin level of two groups of antenatal mothers?

Accepted Answer

Unpaired t-test

Answer

Analysis of variance

Answer

Chi-square test

Answer

Paired t-test

UPSC-CMS 2019 — Community Medicine