Disability-adjusted life years (DALYs) include:
Which of the following are health care delivery indicators? 1. Population per trained birth attendant 2. Population per health/sub centre 3. Doctor-nurse ratio Select the correct answer using the code given below:
Which of the following key action areas are incorporated in the Ottawa Charter? 1. Building healthy public policy 2. Strengthening community action for health 3. Reorienting health services Select the correct answer using the code given below:
Under Chapter XXI of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which of the following code range?
Which of the following diseases are spread by airborne transmission? 1. Influenza 2. Chicken pox 3. Q-fever 4. Psittacosis Select the correct answer using the code given below:
Endemic ascites occurs due to:
The presence of which of the following bacteria in drinking water is an important confirmatory evidence of recent faecal pollution of water?
With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements: 1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030 2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030 3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030 Which of the above statements hold true?
The incidence of diarrhoea is highest among infants in the age group of 6–11 months due to all of the following reasons EXCEPT:
In the context of "Anti-Malaria Month Campaign", consider the following statements: 1. It is observed every year in the month of June 2. It is planned during the Monsoon season 3. It aims to enhance the level of community awareness and participation Select the correct answer using the code given below:
UPSC-CMS 2020 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 21: Disability-adjusted life years (DALYs) include:
- A. Both YLL and YLD (Correct Answer)
- B. Neither YLL nor YLD
- C. Years lost to disability (YLD)
- D. Years of lost life (YLL)
Explanation: ***Both YLL and YLD*** - **DALYs (Disability-Adjusted Life Years)** are a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability, or early death. - They are calculated as the sum of **Years of Life Lost (YLL)** due to premature mortality and **Years Lost due to Disability (YLD)** for people living with a health condition or its consequences. *Neither YLL nor YLD* - This statement is incorrect because DALYs are explicitly designed to integrate both premature mortality (YLL) and the impact of non-fatal health outcomes (YLD). - Excluding both components would render DALYs meaningless as a comprehensive health metric. *Years lost to disability (YLD)* - While **YLD** is a crucial component of DALYs, focusing solely on YLD would ignore the impact of premature mortality. - A healthy life lost due to early death is as significant as years living with a disability in assessing disease burden. *Years of lost life (YLL)* - While **YLL** is an essential component, considering only YLL would overlook the burden of morbidity and disability. - Many chronic diseases cause significant disability and reduced quality of life without necessarily leading to premature death, which YLD accounts for.
Question 22: Which of the following are health care delivery indicators? 1. Population per trained birth attendant 2. Population per health/sub centre 3. Doctor-nurse ratio Select the correct answer using the code given below:
- A. 2 and 3 only
- B. 1 and 2 only
- C. 1 and 3 only
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - All three indicators (Population per trained birth attendant, Population per health/sub centre, and Doctor-nurse ratio) are direct measures reflecting the **availability and distribution of healthcare resources** and personnel. - These metrics help assess the **accessibility and quality** of healthcare delivery within a population. *2 and 3 only* - This option incorrectly excludes "Population per trained birth attendant," which is a crucial indicator of access to **maternal and child healthcare services**. - While "Population per health/sub centre" and "Doctor-nurse ratio" are important, neglecting birth attendants provides an incomplete picture of healthcare delivery. *1 and 2 only* - This option misses the "Doctor-nurse ratio," which is vital for evaluating the **skill mix and capacity** of the healthcare workforce. - An adequate doctor-nurse ratio ensures effective patient care and **resource utilization** within facilities. *1 and 3 only* - This option excludes "Population per health/sub centre," a key indicator of the **physical infrastructure and primary care accessibility** for a population. - The presence and reach of health centers are fundamental to delivering basic healthcare services to the community.
Question 23: Which of the following key action areas are incorporated in the Ottawa Charter? 1. Building healthy public policy 2. Strengthening community action for health 3. Reorienting health services Select the correct answer using the code given below:
- A. 1 and 2 only
- B. 2 and 3 only
- C. 1, 2 and 3 (Correct Answer)
- D. 1 and 3 only
Explanation: ***1, 2 and 3*** - The **Ottawa Charter for Health Promotion** delineates five key action areas, all of which are crucial for health improvement. These include **building healthy public policy**, **creating supportive environments**, **strengthening community action**, **developing personal skills**, and **reorienting health services**. - This option correctly identifies three of the five key action areas, demonstrating a comprehensive understanding of the Charter's framework. *1 and 2 only* - While **building healthy public policy** and **strengthening community action** are indeed key areas in the Ottawa Charter, this option is incomplete as it omits other important action areas. - The Charter's framework is holistic, requiring the integration of all five areas for effective health promotion. *2 and 3 only* - This option correctly includes **strengthening community action** and **reorienting health services**, but it fails to mention other fundamental aspects. - Focusing on only two of the areas would lead to an incomplete strategy for health promotion as envisioned by the Ottawa Charter. *1 and 3 only* - This option correctly identifies **building healthy public policy** and **reorienting health services** but overlooks other essential components of the Ottawa Charter. - A full understanding of the Charter requires recognition of all five action areas rather than just a subset.
Question 24: Under Chapter XXI of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which of the following code range?
- A. U 50.0 – U 50.5
- B. Z 72.0 – Z 72.5 (Correct Answer)
- C. U 10.0 – U 10.5
- D. Z 10.0 – Z 10.5
Explanation: ***Z 72.0 – Z 72.5*** - This **ICD-10 Chapter XXI** code range is specifically assigned to **problems related to lifestyle**, which includes issues such as unhealthy diet, lack of physical activity, and stress. - These codes are used to identify factors influencing health status and contact with health services, contributing to a holistic view of patient care. *U 50.0 – U 50.5* - The **"U" code series** (U00-U99) in ICD-10 is generally reserved for **codes for special purposes**, such as provisional assignment of new diseases of uncertain etiology or for research purposes. - This range does not categorize lifestyle-related problems; instead, it is designated for emerging or yet-to-be-classified conditions. *U 10.0 – U 10.5* - Similar to the previous option, this **"U" code range** is part of the category for **codes for special purposes** and is not used for classifying lifestyle factors. - These codes are typically used for emergency situations, specific research projects, or temporary classifications. *Z 10.0 – Z 10.5* - The **"Z" codes** (Z00-Z99) in ICD-10 are generally used for **factors influencing health status and contact with health services**, but the Z10-Z13 range is specifically for **routine general health examinations** of defined subpopulations. - This range does not classify general lifestyle-related problems but rather specific types of health screenings or check-ups.
Question 25: Which of the following diseases are spread by airborne transmission? 1. Influenza 2. Chicken pox 3. Q-fever 4. Psittacosis Select the correct answer using the code given below:
- A. 3 and 4 only (Correct Answer)
- B. 1 and 3 only
- C. 1 and 4 only
- D. 1, 2, 3 and 4
Explanation: ***3 and 4 only*** - **Q-fever (Coxiella burnetii)** and **Psittacosis (Chlamydia psittaci)** are true **airborne diseases** that spread via droplet nuclei or dust particles <5 μm that remain suspended in air and can travel long distances. - **Q-fever** spreads through inhalation of contaminated aerosols from infected animal products (particularly during parturition in livestock). - **Psittacosis** spreads via inhalation of aerosolized dried bird droppings or respiratory secretions from infected birds. - **Airborne transmission** requires particles small enough to remain suspended in air for extended periods and travel beyond 1-2 meters. *1, 2, 3 and 4* - This option is incorrect because **Influenza** is classified as a **droplet-borne disease**, not airborne. - **Influenza** spreads primarily through large respiratory droplets (>5 μm) that travel <1 meter and settle quickly, requiring close contact for transmission. - **Chickenpox**, while highly contagious, has both airborne and direct contact routes, but the primary emphasis in this question context should be on strict airborne diseases (Q-fever and Psittacosis). - The distinction between droplet and airborne transmission is critical for infection control measures (surgical masks vs N95 respirators). *1 and 3 only* - This option is incorrect as **Influenza** is not an airborne disease but rather spreads via droplet transmission. - While **Q-fever** is correctly identified as airborne, including Influenza makes this combination incorrect. - **Psittacosis** is also airborne and should be included. *1 and 4 only* - This option is incorrect because **Influenza** does not meet the criteria for airborne transmission. - While **Psittacosis** is correctly identified, the inclusion of Influenza and exclusion of Q-fever makes this choice inaccurate. - Both Q-fever and Psittacosis are classic examples of airborne zoonotic infections.
Question 26: Endemic ascites occurs due to:
- A. Fungal toxin
- B. Naturally occurring toxin (Correct Answer)
- C. Bacterial toxin
- D. Viral toxin
Explanation: ***Naturally occurring toxin*** - Endemic ascites, specifically **hepatic veno-occlusive disease (HVOD)** leading to ascites, is primarily caused by **pyrrolizidine alkaloids**. - These are **naturally occurring toxins** found in certain plants (e.g., *Crotalaria*, *Heliotropium*) that contaminate food supplies, particularly in endemic regions. *Fungal toxin* - While some fungal toxins (e.g., aflatoxins) are hepatotoxic, they are more commonly associated with **hepatocellular carcinoma** or acute liver failure rather than endemic ascites due to veno-occlusive disease. - HVOD is specifically linked to plant-derived toxins. *Bacterial toxin* - Bacterial toxins are generally not implicated in the pathogenesis of **endemic ascites** through the mechanism of **veno-occlusive disease**. - Bacterial infections can cause liver damage or sepsis, but not typically the specific form of ascites seen in endemic situations. *Viral toxin* - Viruses, such as hepatitis viruses, can cause chronic liver disease and ascites, but this is due to **viral replication and immune-mediated damage**, not a viral toxin in the traditional sense. - Endemic ascites due to toxins refers specifically to exogenous, non-biological toxins.
Question 27: The presence of which of the following bacteria in drinking water is an important confirmatory evidence of recent faecal pollution of water?
- A. Streptococci
- B. Klebsiella
- C. Clostridium
- D. E. coli (Correct Answer)
Explanation: ***E. coli*** - The presence of **Escherichia coli** (E. coli) in drinking water is a definitive indicator of **recent fecal contamination**. - **E. coli** is a bacterium that normally lives in the intestines of humans and animals and its presence suggests a direct pathway for fecal matter to enter the water supply. *Streptococci* - **Fecal streptococci** (now often referred to as enterococci) can indicate fecal contamination, but they are not as specific as E. coli for **recent human fecal pollution** because they can persist longer in the environment and are found in both human and animal feces. - While useful as an indicator, they are generally considered **less precise for recent human fecal contamination** compared to E. coli. *Klebsiella* - **Klebsiella** species are found in the gastrointestinal tract and can be present in water, but their primary habitat is not exclusively fecal, as they can also be found in soil and on plants. - Therefore, their presence in water is **not as reliable an indicator** of recent fecal pollution as E. coli. *Clostridium* - **Clostridium perfringens** is a spore-forming bacterium found in feces, but its spores are highly resistant and can survive in the environment for extended periods. - Its presence indicates **past or intermittent fecal contamination** rather than recent contamination, making it less suitable for confirming recent fecal pollution.
Question 28: With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements: 1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030 2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030 3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030 Which of the above statements hold true?
- A. 1 and 3 only
- B. 1 and 2 only
- C. 2 and 3 only
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - All three statements accurately reflect the **core targets** set by the Global Technical Strategy for Malaria (2016-2030). - These ambitious goals aim to achieve significant reductions in malaria burden and eventual eradication in many regions. *1 and 3 only* - This option is incorrect because it omits statement 2, which is a verified goal for **reducing malaria case incidence**. - All three statements are indeed part of the strategy's published objectives. *1 and 2 only* - This option is incorrect as it excludes statement 3 regarding the **elimination of malaria** from at least 35 countries. - The strategy encompasses all three stated objectives for global malaria control. *2 and 3 only* - This option is incorrect because it fails to include statement 1, which specifies the target for **reducing malaria mortality rates**. - The strategy explicitly addresses all three aspects: mortality, incidence, and country-level elimination.
Question 29: The incidence of diarrhoea is highest among infants in the age group of 6–11 months due to all of the following reasons EXCEPT:
- A. Introduction of foods which may be contaminated
- B. Eruption of teeth (Correct Answer)
- C. Declining level of maternal antibodies
- D. Direct contact with human or animal faeces
Explanation: ***Eruption of teeth*** - While teething can cause discomfort and sometimes lead to mild, temporary changes in bowel movements, it is **not a direct cause of diarrhea** and does not significantly increase the incidence of diarrheal diseases in this age group. - The physiological process of tooth eruption itself doesn't introduce pathogens that cause diarrheal illness or significantly compromise immune defenses in a way that leads to increased diarrhea. *Introduction of foods which may be contaminated* - This is a significant factor as infants begin complementary feeding, introducing them to **foods prepared with unhygienic practices** or contaminated water. - Exposure to new pathogens through solid foods increases the risk of **gastrointestinal infections**. *Declining level of maternal antibodies* - Maternal antibodies provided through breast milk decline significantly around 6 months, reducing the infant's **passive immunity** and making them more susceptible to infections, including those causing diarrhea. - This immunological gap coincides with the period when infants are more exposed to environmental pathogens. *Direct contact with human or animal faeces* - As infants become more mobile and explore their environment by crawling and putting objects in their mouths, their risk of exposure to **fecal-oral pathogens** from contaminated surfaces or hands increases. - Poor hygiene practices in handling infant waste or animal contact can lead to increased transmission of diarrheal causing agents.
Question 30: In the context of "Anti-Malaria Month Campaign", consider the following statements: 1. It is observed every year in the month of June 2. It is planned during the Monsoon season 3. It aims to enhance the level of community awareness and participation Select the correct answer using the code given below:
- A. 1 and 3 (Correct Answer)
- B. 1 and 2
- C. 2 and 3
- D. 3 only
Explanation: ***1 and 3*** - The **Anti-Malaria Month Campaign** is observed annually in **June** to raise awareness and implement preventive measures ahead of peak malaria transmission during the monsoon season. - A primary objective is to **enhance community awareness and participation** in malaria control efforts through activities like vector control (larvicidal measures, source reduction), early case detection, and prompt treatment. - Statement 2 is incorrect because the campaign is **planned and launched in June**, which coincides with the **onset** of monsoon, but the planning phase occurs **before** the monsoon rains intensify. The phrase "planned during monsoon" incorrectly suggests the planning happens during the monsoon period, whereas planning occurs in the pre-monsoon period (April-May) for implementation starting in June. *1 and 2* - While statement 1 is correct (observed in June) and statement 3 would be correct (enhancing participation), statement 2 creates confusion about timing. - The campaign **planning occurs before the monsoon season** (April-May), and **implementation begins in June** as monsoon arrives. Saying it is "planned during monsoon" is technically inaccurate. *2 and 3* - Statement 2 is incorrect as explained above - the campaign planning precedes the monsoon season. - While statement 3 about enhancing community participation is correct, this combination is wrong due to statement 2. *3 only* - This misses statement 1, which is clearly correct - the Anti-Malaria Month Campaign has been traditionally observed in **June** every year as part of the National Vector Borne Disease Control Programme (NVBDCP). - Both statements 1 and 3 are correct, making this option incomplete.