UPSC-CMS 2019 - Community Medicine Practice Questions

Q: In a population of 5000, there are 19 % eligible couples. To achieve a couple protection rate (CPR) of 60 %, how many of these should be covered for family planning services?

570. ***570*** - First, calculate the total number of **eligible couples**: 19% of 5000 = (19/100) * 5000 = **950 couples**. - To achieve a **Couple Protection Rate (CPR) of 60%**, calculate 60% of the eligible couples: 60% of 950 = (60/100) * 950 = **570 couples**. *550* - This option indicates a protection rate of approximately **57.9%** (550/950 * 100), which is less than the target of 60%. - It does not meet the specified target for **Couple Protection Rate**. *530* - This option would result in a protection rate of approximately **55.8%** (530/950 * 100), which is significantly lower than the desired 60%. - This value is an underestimation of the number of couples needed to achieve the target CPR. *590* - This option indicates a protection rate of approximately **62.1%** (590/950 * 100), which exceeds the target of 60%. - While protecting more couples is generally good, the question asks for how many *should* be covered to achieve *60%* specifically, making 570 the exact answer.

Q: Vaccine-associated Paralytic Poliomyelitis (VAPP) is mostly observed due to which of the following vaccine strain serotype?

Type–2 only. ***Type–2 only*** - Vaccine-associated paralytic poliomyelitis (VAPP) is primarily linked to the **Sabin type 2 oral poliovirus vaccine (OPV)** strain. - This is because the type 2 strain in OPV is inherently more neurovirulent and genetically unstable compared to the other serotypes, making it more prone to reverting to a **paralytogenic form**. *Type–1 only* - While type 1 poliovirus can cause wild poliomyelitis and has been part of OPV, it is **less commonly associated with VAPP** compared to type 2. - The type 1 component of OPV is generally more genetically stable and less likely to revert to a neurovirulent form in vaccinated individuals. *Type–3* - Similar to type 1, the type 3 poliovirus strain in OPV is also **less frequently implicated in VAPP** than type 2. - Type 3 poliovirus has been eradicated globally in both its wild and vaccine-derived forms due to successful vaccination campaigns. *Both Type-1 and 2* - Although VAPP can theoretically occur with vaccine strains of both type 1 and type 2, the **overwhelming majority of cases are caused by the type 2 strain**. - The risk of VAPP from type 1 is significantly lower, making "type 2 only" the most accurate answer for the highest incidence.

Q: Association between hardness of drinking water and death rate from cardiovascular diseases is:

Inverse. ***Inverse*** * Studies have often shown an **inverse relationship** between water hardness and cardiovascular disease mortality. * This means that areas with **harder drinking water**, which contains more minerals like calcium and magnesium, tend to have **lower rates of cardiovascular disease deaths**. *Direct* * A direct association would imply that **harder water leads to higher death rates**, which is generally not supported by epidemiological evidence. * If the relationship were direct, promoting soft water consumption might be a public health goal for cardiovascular health, which is not the case. *No association* * While the association isn't universally strong or consistently replicated in all studies, many large-scale epidemiological studies suggest a **protective effect** of hard water components. * Therefore, stating no association completely would ignore a significant body of research suggesting a benefit. *Association is obtained in presence of confounders* * While **confounders** (such as diet, lifestyle, socioeconomic status, and other geographical factors) are always a consideration in epidemiological studies, many analyses have attempted to control for these variables. * The observed inverse association often persists even after adjusting for known confounders, suggesting it's not solely due to them.

Q: An adult weighs 73 kgs and has a height of 1.75 meters. For the purpose of classification of overweight and obesity as per WHO recommendation, this person will be classified as:

Normal. ***Normal*** - This individual's **Body Mass Index (BMI)** is calculated as weight (kg) / height (m)^2. For 73 kg and 1.75 m, BMI = 73 / (1.75 * 1.75) = 73 / 3.0625 = **23.83 kg/m²**. - According to WHO classifications, a BMI between **18.5 and 24.9 kg/m²** falls within the **normal weight** range. *Underweight* - An individual is classified as **underweight** if their BMI is **less than 18.5 kg/m²**. - This option is incorrect because the calculated BMI of 23.83 kg/m² is well above this threshold. *Preobese* - The term **preobese** is often used interchangeably with **overweight**, specifically for a BMI between **25.0 and 29.9 kg/m²**. - This option is incorrect as the calculated BMI of 23.83 kg/m² does not fall into this range. *Overweight* - An individual is classified as **overweight** if their BMI is between **25.0 and 29.9 kg/m²**. - This option is incorrect because the calculated BMI of 23.83 kg/m² is below the threshold for overweight.

Q: All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:

Vaccine development for streptococcal infection. ***Vaccine development for streptococcal infection*** - While **vaccine development** for Group A Streptococcus (GAS) is a long-term goal in controlling Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD), it was **not an immediate component** of the Jai Vigyan Mission Mode project. - The mission focused on existing, actionable strategies for community control, rather than basic research and development of new interventions. *To study the epidemiology of streptococcal sore throats* - Understanding the **epidemiology of streptococcal sore throats** (the precursor to RF) is crucial for identifying high-risk populations and tailoring intervention strategies. - This component helps in mapping the incidence and prevalence of infections required to implement effective control strategies. *Antibiotic treatment of streptococcal sore throats* - **Prompt antibiotic treatment** of streptococcal sore throats is a cornerstone of primary prevention for RF, preventing the immune response that leads to the disease. - This is a direct, immediate intervention aimed at breaking the chain of infection and disease progression. *To establish registries for RF and RHD* - Establishing **registries for RF and RHD** is essential for monitoring disease burden, tracking outcomes, and evaluating the effectiveness of control programs. - Registries provide valuable data for public health planning and resource allocation.

Q: What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030? Consider the following statements: 1. Impact 2. Coverage/risk factor 3. Risk factor/determinants Which of the above statement(s) correctly identifies the type of indicator?

1 only. ***1 only*** - Sustainable Development Goal target 3.4, aiming for a one-third reduction in **premature mortality** from NCDs, is an **impact indicator**. - **Impact indicators** measure the overall effect of interventions on health outcomes, such as mortality rates. *2 and 3* - **Coverage/risk factor indicators** measure the proportion of the target population receiving an intervention or the prevalence of risk factors. - While reducing NCD mortality is related to controlling risk factors, the target itself directly measures a reduction in **death (an impact)**, not the risk factor prevalence or intervention coverage. *3 only* - **Risk factor/determinant indicators** specify factors that contribute to the disease or health outcome, like smoking rates or unhealthy diet. - The target of reducing **premature mortality** is a direct outcome of these risk factors, making it an impact indicator rather than a separate risk factor indicator. *1 and 3* - Although risk factors are determinants of NCD mortality, the **reduction in mortality** itself is a measure of the ultimate outcome or impact, not solely a risk factor. - The core of SDG 3.4 is the decrease in deaths, which unequivocally points to it being an **impact indicator**.

Q: Which one of the following occupational diseases is the most common cause of permanent disability and mortality?

Silicosis. ***Silicosis*** - **Silicosis** is the **most common serious occupational lung disease worldwide**, caused by inhaling **crystalline silica dust** from mining, quarrying, stone-cutting, and construction work. - It leads to **progressive massive fibrosis** with severe impairment of lung function, resulting in the **highest global burden of occupational disability and mortality** among pneumoconioses. - Particularly prevalent in **developing countries** including India, where exposure remains widespread in unregulated industries. - Increases risk of **tuberculosis, COPD, and lung cancer**, further contributing to mortality. *Byssinosis* - Caused by exposure to **cotton dust** in textile workers, leading to chest tightness and airway obstruction. - Generally **reversible in early stages** if exposure is eliminated. - Significantly **lower rates of permanent disability and mortality** compared to silicosis. *Anthracosis* - Also known as **coal worker's pneumoconiosis**, caused by inhaling coal dust. - Can progress to complicated pneumoconiosis, but is generally **less fibrogenic than silicosis**. - Lower global prevalence due to improved mining safety and decline of coal mining in many regions. *Asbestosis* - Caused by inhaling **asbestos fibers**, leading to diffuse pulmonary fibrosis. - While highly serious and associated with **mesothelioma and lung cancer**, its prevalence has **decreased significantly** due to asbestos bans in many countries. - Silicosis surpasses it in **overall global burden** due to continued widespread silica exposure.

Q: As per WHO recommendations which one of the following mumps vaccine strains should NOT be used in National Immunization Programme?

Rubini. ***Rubini*** - The **Rubini strain** of mumps vaccine is not recommended by the WHO for national immunization programs due to its **low immunogenicity** and **reduced efficacy**. - Studies have shown that the antibody response and protection offered by the Rubini strain are inferior compared to other widely used mumps vaccine strains. *Jeryl Lynn* - The **Jeryl Lynn strain** is a widely used and well-established mumps vaccine strain, with a good track record of efficacy and safety. - It is one of the strains commonly found in combined measles, mumps, and rubella **(MMR) vaccines** and is recommended by the WHO. *RIT 4385* - **RIT 4385** is another name for the **Jeryl Lynn strain** of mumps vaccine, referring to a specific manufacturing process or original isolate. - As such, it is a recommended and effective strain for national immunization programs. *L-Zagreb* - The **L-Zagreb strain** is a mumps vaccine strain that is also recommended by the WHO for inclusion in national immunization programs due to its demonstrated efficacy and safety profile. - It is used in various parts of the world as a component of MMR vaccines.

Question 1

In a population of 5000, there are 19 % eligible couples. To achieve a couple protection rate (CPR) of 60 %, how many of these should be covered for family planning services?

Accepted Answer

570

Answer

550

Answer

530

Answer

590

Question 2

Vaccine-associated Paralytic Poliomyelitis (VAPP) is mostly observed due to which of the following vaccine strain serotype?

Accepted Answer

Type–2 only

Answer

Type–1 only

Answer

Type–3

Answer

Both Type-1 and 2

Question 3

The specific goals for 2025 under the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) are all of the following EXCEPT:

Accepted Answer

Reduce the incidence of severe pneumonia by 90 % in children less than 5 years of age compared to 2010 levels

Answer

Reduce incidence of severe diarrhea by 75 % in children less than 5 years of age compared to 2010 levels

Answer

Reduce mortality from pneumonia in children less than 5 years of age to fewer than 3 per 1000 live births

Answer

Reduce mortality from diarrhea in children less than 5 years of age to fewer than 1 per 1000 live births

Question 4

Association between hardness of drinking water and death rate from cardiovascular diseases is:

Accepted Answer

Inverse

Answer

Direct

Answer

No association

Answer

Association is obtained in presence of confounders

Question 5

An adult weighs 73 kgs and has a height of 1.75 meters. For the purpose of classification of overweight and obesity as per WHO recommendation, this person will be classified as:

Accepted Answer

Normal

Answer

Underweight

Answer

Preobese

Answer

Overweight

Question 6

Which one of the following statements regarding WHO Global Action Plan for the prevention and control of NCDs (2013–2020) is NOT correct?

Accepted Answer

A 10 percent relative reduction in mean population intake of salt/sodium

Answer

Halt the rise of diabetes and obesity

Answer

At least 10 percent relative reduction in the harmful use of alcohol as appropriate within national context

Answer

A 10 percent relative reduction in prevalence of insufficient physical activity

Question 7

All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:

Accepted Answer

Vaccine development for streptococcal infection

Answer

To study the epidemiology of streptococcal sore throats

Answer

Antibiotic treatment of streptococcal sore throats

Answer

To establish registries for RF and RHD

Question 8

What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030?

Consider the following statements:
1. Impact
2. Coverage/risk factor  
3. Risk factor/determinants

Which of the above statement(s) correctly identifies the type of indicator?

Accepted Answer

1 only

Answer

2 and 3

Answer

3 only

Answer

1 and 3

Question 9

Which one of the following occupational diseases is the most common cause of permanent disability and mortality?

Accepted Answer

Silicosis

Answer

Byssinosis

Answer

Anthracosis

Answer

Asbestosis

Question 10

As per WHO recommendations which one of the following mumps vaccine strains should NOT be used in National Immunization Programme?

Accepted Answer

Rubini

Answer

Jeryl Lynn

Answer

RIT 4385

Answer

L-Zagreb

UPSC-CMS 2019 — Community Medicine