Community Medicine
9 questionsAll of the following are global targets for WHO Global Action Plan (2013–2020) for Prevention and Control of NCDs, EXCEPT:
Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in which of the following infectious diseases? 1. Tuberculosis 2. Leprosy 3. Chronic empyema Select the correct answer using the code given below:
In the context of NCD prevention and control in India, the extent of relative reduction in household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:
Consider the following criteria which may indicate elimination of lymphatic filariasis in a community: 1. When lymphatic filariasis ceases to be a public health problem in the community 2. When the number of microfilaria carriers declines to 1.5 % within the community 3. When children born in the community after the initiation of elimination programme are free from circulating antigenaemia Which of the criteria stated above hold true?
Hold over time of cold chain equipment depends on all of the following factors EXCEPT:
Which of the following statements regarding Physical Quality of Life Index (PQLI) are correct? 1. It consolidates infant mortality, life expectancy at age one, and literacy 2. It does not measure economic growth but measures the result of economic policies 3. For each component, the performance of individual countries is placed on a scale of 0-100 Select the correct answer using the code given below:
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:
UPSC-CMS 2020 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 101: All of the following are global targets for WHO Global Action Plan (2013–2020) for Prevention and Control of NCDs, EXCEPT:
- A. A 30% relative reduction in mean population intake of salt/sodium
- B. A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases
- C. At least 10 % relative reduction in the harmful use of alcohol
- D. A 15% relative reduction in healthcare costs related to NCDs (Correct Answer)
Explanation: ***A 15% relative reduction in healthcare costs related to NCDs*** - While reducing healthcare costs is an important outcome of NCD prevention, it was **not explicitly stated as one of the nine global targets** in the WHO Global Action Plan (2013–2020) for the Prevention and Control of NCDs. - The targets primarily focused on **risk factor reduction and mortality reduction**, rather than direct cost reduction percentages. *A 30% relative reduction in mean population intake of salt/sodium* - This is one of the **specified global targets** of the WHO NCD Global Action Plan, aiming to reduce a significant dietary risk factor for cardiovascular diseases. - High sodium intake is a major contributor to **hypertension**, a leading risk factor for NCDs. *A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases* - This represents the **overarching mortality reduction target** for the key NCDs, making it a central goal of the WHO action plan. - Reducing premature mortality is a direct measure of the **effectiveness of NCD prevention and control strategies**. *At least 10 % relative reduction in the harmful use of alcohol* - This is another **identified global target** within the WHO NCD Global Action Plan, recognizing alcohol as a major modifiable risk factor for NCDs. - Harmful alcohol use contributes to various NCDs, including **liver disease, cardiovascular disease, and certain cancers**.
Question 102: Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in which of the following infectious diseases? 1. Tuberculosis 2. Leprosy 3. Chronic empyema Select the correct answer using the code given below:
- A. 1, 2 and 3
- B. 2 and 3 only
- C. 1 and 2 only (Correct Answer)
- D. 1 and 3 only
Explanation: ***1 and 2 only*** - Under the **Employees' State Insurance (ESI) Central Rules, 1950**, extended sickness benefit is provided for specified long-term diseases requiring prolonged treatment. - The diseases covered include **Tuberculosis** and **Leprosy**, both of which require extended treatment periods and justify enhanced support. - **Chronic empyema is NOT included** in the list of diseases eligible for extended sickness benefit under the ESI Scheme. - Other diseases covered include mental illness and malignant diseases (cancer). *1, 2 and 3* - This option is incorrect because **chronic empyema** is not listed among the diseases eligible for extended sickness benefit under ESI regulations. - While empyema may require medical care, it does not qualify for the specific extended sickness benefit provision. *2 and 3 only* - This option is incorrect as it omits **Tuberculosis**, which is a major disease specifically listed for extended sickness benefit under the ESI Scheme. - It also incorrectly includes chronic empyema, which is not covered. *1 and 3 only* - This option is incorrect because it includes **chronic empyema**, which is not eligible for extended sickness benefit. - While Tuberculosis is correctly included, the combination is inaccurate per ESI regulations.
Question 103: In the context of NCD prevention and control in India, the extent of relative reduction in household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:
- A. 50 % (Correct Answer)
- B. 40 %
- C. 60 %
- D. 30 %
Explanation: ***50 %*** - The **WHO Global Action Plan for Prevention and Control of NCDs 2013-2020** includes voluntary global targets, which India has adopted through its **National Action Plan for NCDs**. - Target 5 of this action plan addresses environmental risk factors and aims for a **50% relative reduction** in household use of solid fuels as a primary source of energy for cooking by 2025. - This target is aligned with efforts to improve **indoor air quality** and reduce the burden of **respiratory and cardiovascular NCDs** associated with solid fuel combustion and household air pollution. *40 %* - While significant, a **40% reduction** is less ambitious than the established national target for solid fuel use reduction adopted from WHO's voluntary global targets. - This figure does not correspond to the specific goal outlined in India's NCD prevention strategies for 2025 regarding solid fuels. *60 %* - A **60% reduction** would be a more aggressive target, exceeding the current official target set for 2025 in the context of NCD prevention. - While desirable for public health impact, it is not the officially stated target adopted by India from the WHO Global Action Plan for solid fuel use reduction by 2025. *30 %* - A **30% reduction** represents a less ambitious target and would likely be insufficient to achieve the desired public health impact on NCDs related to indoor air pollution. - This figure falls short of the adopted national health policy goals for household solid fuel reduction by 2025 under the NCD action framework.
Question 104: Consider the following criteria which may indicate elimination of lymphatic filariasis in a community: 1. When lymphatic filariasis ceases to be a public health problem in the community 2. When the number of microfilaria carriers declines to 1.5 % within the community 3. When children born in the community after the initiation of elimination programme are free from circulating antigenaemia Which of the criteria stated above hold true?
- A. 1, 2 and 3 (Correct Answer)
- B. 1 and 3 only
- C. 1 and 2 only
- D. 2 and 3 only
Explanation: ***1, 2 and 3*** - All three criteria reflect the **WHO framework for elimination of lymphatic filariasis** as a public health problem. - **Criterion 1**: Represents the overarching goal that the disease burden and transmission have been reduced such that it no longer poses a significant public health threat in the community. - **Criterion 2**: A **microfilaria carrier rate < 1-1.5%** indicates substantial reduction in active infection and transmission potential in the population. - **Criterion 3**: **Transmission Assessment Survey (TAS)** criteria include demonstrating that children born after program initiation are free from circulating filarial antigen (< 2% antigen prevalence in 6-7 year age group), confirming **interruption of transmission**. - Together, these criteria provide epidemiological, clinical, and transmission-based evidence of elimination. *1 and 3 only* - This option incorrectly excludes the **decline in microfilaria carrier prevalence** as a criterion. - Reduction in **microfilaremia prevalence** is a critical epidemiological indicator showing decreased infection reservoir and reduced transmission potential in the community. *1 and 2 only* - This option incorrectly excludes the criterion related to **children being free from circulating antigenaemia**. - The **TAS (Transmission Assessment Survey)** uses antigen testing in children as the primary tool to verify interruption of transmission, making this criterion essential for confirming elimination. *2 and 3 only* - This option excludes the overarching criterion that **lymphatic filariasis ceases to be a public health problem**. - While specific measurable criteria (2 and 3) are important, the overall assessment that the disease no longer constitutes a public health problem remains a fundamental elimination indicator.
Question 105: Hold over time of cold chain equipment depends on all of the following factors EXCEPT:
- A. Condition of icepack lining
- B. Types of vaccines kept (Correct Answer)
- C. Ambient temperature
- D. Quantity of vaccines kept
Explanation: ***Types of vaccines kept*** - The **type of vaccine** stored does not directly influence how long the cold chain equipment can maintain its temperature. - The physical parameters of the equipment and its contents, not the biological nature of the vaccines, determine the hold-over time. *Condition of icepack lining* - The **integrity and condition of icepack lining** are crucial as damaged linings can lead to faster melting of ice, reducing the hold-over time. - A good lining ensures optimal insulation and prolonged effectiveness of the icepacks in maintaining cold temperatures. *Ambient temperature* - **Higher ambient temperatures** will naturally cause the cold chain equipment to warm up more quickly, thus reducing its hold-over time. - Conversely, lower ambient temperatures will extend the period for which the equipment can maintain the required temperature range. *Quantity of vaccines kept* - An **increased quantity of vaccines (or other contents)** within the cold chain equipment can influence the hold-over time, particularly if they are not pre-cooled. - The thermal mass of the contents can either help maintain temperature if pre-cooled or absorb cold if warmer, affecting the equilibrium and duration of optimal temperature.
Question 106: Which of the following statements regarding Physical Quality of Life Index (PQLI) are correct? 1. It consolidates infant mortality, life expectancy at age one, and literacy 2. It does not measure economic growth but measures the result of economic policies 3. For each component, the performance of individual countries is placed on a scale of 0-100 Select the correct answer using the code given below:
- A. 1 and 2 only
- B. 1 and 3 only
- C. 2 and 3 only
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - The **Physical Quality of Life Index (PQLI)** indeed consolidates **infant mortality**, **life expectancy at age one**, and **literacy rate** as its three core components, reflecting key aspects of well-being. - PQLI specifically aims to measure the **outcomes of economic policies** on human well-being rather than economic growth itself, making it a valuable tool for assessing social progress. The PQLI scales each component from **0 to 100**, where 0 represents the worst performance (e.g., highest infant mortality) and 100 represents the best (e.g., lowest infant mortality), allowing for standardized comparison across countries. *1 and 2 only* - This option incorrectly omits the third correct statement regarding the **0-100 scaling** of individual components, which is a fundamental aspect of how the PQLI is calculated and interpreted. - While statements 1 and 2 are accurate individually, they do not encompass all the correct information provided in the question's premise. *1 and 3 only* - This option omits the correct statement that PQLI measures the **results of economic policies** rather than economic growth, which is a crucial distinguishing characteristic of the index. - While statements 1 and 3 are correct, they do not fully capture all the accurate descriptions of the PQLI. *2 and 3 only* - This option incorrectly excludes the first statement, which correctly identifies the three core components of the PQLI: **infant mortality**, **life expectancy at age one**, and **literacy**. - Without including the components, the understanding of PQLI is incomplete, despite accurately describing other features.
Question 107: 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 108: 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 109: 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.
Pharmacology
1 questionsWhich one of the following is the antibiotic of choice for the prevention of Rheumatic Heart Disease?
UPSC-CMS 2020 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 101: Which one of the following is the antibiotic of choice for the prevention of Rheumatic Heart Disease?
- A. Benzathine Benzyl Penicillin (Correct Answer)
- B. Doxycycline
- C. Procaine Penicillin
- D. Ciprofloxacin
Explanation: ***Benzathine Benzyl Penicillin*** - It is the antibiotic of choice for the **prevention of Rheumatic Heart Disease (RHD)** due to its **long-acting nature** and effectiveness against **Group A Streptococcus (GAS)**. - A single intramuscular injection provides **sustained therapeutic levels** for several weeks, crucial for preventing recurrent GAS infections that lead to RHD. *Doxycycline* - Not effective for **primary prevention of Rheumatic Fever** or RHD as it is not a first-line agent against **Group A Streptococcus**. - Mainly used for **atypical bacteria** and certain parasitic infections. *Procaine Penicillin* - It has a shorter duration of action compared to **benzathine penicillin**. - Requires more frequent injections, making it less suitable for **long-term prophylaxis** in RHD prevention. *Ciprofloxacin* - This is a **fluoroquinolone antibiotic** and is not the antibiotic of choice for **Group A Streptococcus infections**. - Its use in this context could contribute to **antibiotic resistance** without providing effective prophylaxis for RHD.