UPSC-CMS 2022 — Community Medicine
27 Previous Year Questions with Answers & Explanations
Amongst the following, the Pearl Index is highest with
As per the PC & PNDT Act, permission will be given to perform the tests for detection of which of the following?
In swimming pools, the free residual chlorine required for providing adequate protection against bacterial and viral agents should be
Which of the following will be target population for screening of diabetes?
With reference to Indian men, who can be categorized as carrying out 'moderate work', what is the Recommended Dietary Allowance (RDA) of thiamine (in mg/day)?
Which of the following is the most fundamental criterion that must be met by a disease before it is to be considered suitable for a screening programme? 1. The natural history of the disease should be adequately understood. 2. No effective treatment should exist for the disease. 3. The disease should not have a recognizable latent or asymptomatic stage. 4. There should be a test that can detect the disease prior to onset of signs and symptoms.
As a part of the Universal Immunization Programme in India, the Inactivated Polio Vaccine (IPV) given as fractional IPV by intradermal route is first administered at what age?
Consider the following : 1. Intravenous tubes 2. Catheters 3. Gloves 4. Blood bags Which of the above-mentioned biomedical wastes will be segregated in Red bag as per the Biomedical Waste Management Rules, 2016?
Which of the following is NOT required for calculating the Human Development Index? 1. Life expectancy at birth 2. Infant mortality rate 3. Gross national income per capita 4. Mean years of schooling
Which of the following statements regarding the Open Vial Policy, 2015 are correct? 1. It applies only for DPT, TT, Hepatitis B, OPV and Liquid Pentavalent vaccine. 2. Vaccine vials opened in session-site can be used again provided a vaccine vial monitor has not reached the discard point. 3. Open vial should never be submerged in water. 4. Open vials of BCG, Measles and JE should be preserved till the next immunization session.
UPSC-CMS 2022 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 1: Amongst the following, the Pearl Index is highest with
- A. combined oral contraceptives
- B. calendar rhythm method (Correct Answer)
- C. barrier contraceptives
- D. intrauterine contraceptive devices
Explanation: ***calendar rhythm method*** - The **Pearl Index** measures the number of unintended pregnancies per 100 women-years of exposure. A higher Pearl Index signifies a **less effective** contraceptive method. - The calendar rhythm method, due to its reliance on estimations and user adherence, has a significantly higher failure rate compared to other methods, leading to the **highest Pearl Index**. *combined oral contraceptives* - **Combined oral contraceptives** have a relatively low Pearl Index, especially with perfect use, as they are highly effective in preventing ovulation. - Their effectiveness can be reduced by **missed pills** or interactions with certain medications. *barrier contraceptives* - **Barrier methods** like condoms or diaphragms have a moderate Pearl Index, as their effectiveness depends on consistent and correct use. - Breakage or incorrect application can lead to **method failure**. *intrauterine contraceptive devices* - **Intrauterine contraceptive devices (IUCDs)**, both hormonal and copper, are among the most effective long-acting reversible contraceptives, resulting in a very low Pearl Index. - Once inserted, they require no daily user action, contributing to their **high efficacy**.
Question 2: As per the PC & PNDT Act, permission will be given to perform the tests for detection of which of the following?
- A. Sex-linked genetic diseases
- B. Chromosomal abnormalities
- C. Haemoglobinopathies
- D. All of the above (Correct Answer)
Explanation: ***All of the above*** - The **PC & PNDT Act** (Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994) permits prenatal diagnostic procedures specifically for detection of **chromosomal abnormalities**, **genetic metabolic diseases**, **haemoglobinopathies**, **sex-linked genetic diseases**, and **congenital anomalies** when there are medical indications. - All three conditions listed in the options (**sex-linked genetic diseases**, **chromosomal abnormalities**, and **haemoglobinopathies**) are explicitly mentioned in the Act as permissible reasons for prenatal testing. - The key principle is that these tests must be conducted only for detection of genetic/congenital abnormalities and **not for sex determination**, which is the primary prohibition under the Act. - Therefore, permission will be given for detection of all the conditions mentioned. *Why each individual option alone would be incomplete* - While each of the three conditions (**sex-linked genetic diseases**, **chromosomal abnormalities**, **haemoglobinopathies**) is individually permitted under the Act, selecting any single option would be incomplete. - The Act permits testing for all these categories of genetic disorders, not just one specific type. - This makes "All of the above" the most comprehensive and accurate answer.
Question 3: In swimming pools, the free residual chlorine required for providing adequate protection against bacterial and viral agents should be
- A. 1.5 mg/litre
- B. 0.5 mg/litre
- C. 2.0 mg/litre
- D. 1.0 mg/litre (Correct Answer)
Explanation: ***1.0 mg/litre*** - A free residual chlorine concentration of **1.0 mg/litre (or 1 part per million)** is considered the optimal standard for **swimming pool water disinfection** to effectively inactivate bacterial and viral pathogens. - This level ensures adequate disinfectant capacity without causing significant eye or skin irritation to swimmers. *1.5 mg/litre* - While a higher concentration offers stronger disinfection, **1.5 mg/litre** is generally **not the standard recommended optimum** for free residual chlorine in swimming pools as it can lead to increased irritation. - This level might be considered if there's a specific need for boosted disinfection, but it's above the typical desired range for routine maintenance. *0.5 mg/litre* - A free residual chlorine level of **0.5 mg/litre** is often considered the **minimum acceptable level** but may not provide a sufficient safety margin for sustained disinfection, especially in heavily used pools. - It might offer **insufficient protection** against a rapid influx of contaminants or heat-stable pathogens. *2.0 mg/litre* - A free residual chlorine level of **2.0 mg/litre** is typically **too high** for routine swimming pool operation as it can cause significant **eye and skin irritation**, as well as damage to pool equipment. - This concentration is usually reserved for **shock treatment** or when addressing a severe contamination event, not for continuous maintenance.
Question 4: Which of the following will be target population for screening of diabetes?
- A. People over 40 years of age
- B. People with family history of diabetes
- C. Women who have had a baby weighing more than 4·5 kg
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - All listed groups—**people over 40 years of age**, **individuals with a family history of diabetes**, and **women who have had a baby weighing more than 4.5 kg**—are considered high-risk populations for developing diabetes. - Screening these groups is a **cost-effective strategy** to identify diabetes early, allowing for timely intervention and prevention of complications. *People over 40 years of age* - **Age** is a significant risk factor for type 2 diabetes, with incidence progressively increasing after 40 due to decreased insulin sensitivity. - Routine screening is recommended by guidelines for adults in this age group, regardless of other risk factors. *People with family history of diabetes* - A **genetic predisposition** plays a crucial role in the development of type 2 diabetes, making a family history a strong indicator for increased risk. - Screening is essential for these individuals to detect the condition early, even if they are otherwise asymptomatic. *Women who have had a baby weighing more than 4·5 kg* - Delivering a **large-for-gestational-age infant** (macrosomia) is a strong indicator of prior **gestational diabetes (GDM)**, even if not formally diagnosed at the time. - Women with a history of GDM have a significantly increased risk of developing type 2 diabetes later in life.
Question 5: With reference to Indian men, who can be categorized as carrying out 'moderate work', what is the Recommended Dietary Allowance (RDA) of thiamine (in mg/day)?
- A. 1.2
- B. 1.8
- C. 1.0
- D. 1.4 (Correct Answer)
Explanation: ***1.4*** - The **Recommended Dietary Allowance (RDA) of thiamine** for Indian men performing **moderate work** is established at **1.4 mg/day** as per **ICMR 2020 guidelines**. - This recommendation is based on metabolic needs considering average physical activity levels, energy expenditure, and preventing deficiency symptoms. - The RDA ensures adequate thiamine intake for carbohydrate metabolism and nervous system function. *1.2* - This value represents the older RDA from previous ICMR guidelines. - While this was the recommended allowance in earlier versions, the current ICMR 2020 guidelines have updated the requirement to 1.4 mg/day for men with moderate activity. - This lower value may not fully meet the metabolic demands as per current recommendations. *1.8* - This value significantly exceeds the standard RDA for moderate work and might be recommended for individuals with higher energy expenditure or heavy physical activity. - For most Indian men performing moderate work, this intake would be considered higher than necessary. *1.0* - This value is below the recommended allowance for Indian men with moderate work. - This intake would not fully meet the metabolic demands, increasing the risk of suboptimal thiamine status and potential deficiency symptoms over time, especially during periods of increased carbohydrate intake.
Question 6: Which of the following is the most fundamental criterion that must be met by a disease before it is to be considered suitable for a screening programme? 1. The natural history of the disease should be adequately understood. 2. No effective treatment should exist for the disease. 3. The disease should not have a recognizable latent or asymptomatic stage. 4. There should be a test that can detect the disease prior to onset of signs and symptoms.
- A. 4. There should be a test that can detect the disease prior to onset of signs and symptoms.
- B. 3. The disease should not have a recognizable latent or asymptomatic stage.
- C. 1. The natural history of the disease should be adequately understood. (Correct Answer)
- D. 2. No effective treatment should exist for the disease.
Explanation: ***The natural history of the disease should be adequately understood.*** * This is the **most fundamental criterion** because understanding the natural history (progression from asymptomatic to symptomatic disease) allows for the identification of a **critical window** for early intervention through screening. * Without this knowledge, it's impossible to determine when to screen, what to screen for, or whether early detection will lead to a better outcome. *There should be a test that can detect the disease prior to onset of signs and symptoms.* * While important, the existence of a detectable test *before* symptoms is only useful if the **natural history** is understood, allowing for appropriate timing and interpretation of the test. * A test without understanding the disease's progression might lead to **overdiagnosis** or diagnosis at a stage where intervention is no longer effective. *The disease should not have a recognizable latent or asymptomatic stage.* * This statement is incorrect; a disease *must* have a **recognizable latent or asymptomatic stage** to be suitable for screening. * Screening aims to detect disease **before** symptoms appear, making the existence of such a stage essential for successful early intervention. *No effective treatment should exist for the disease.* * This statement is incorrect; for a screening program to be beneficial, an **effective treatment must exist** for the disease once detected. * Screening without effective treatment options would merely lead to earlier diagnosis without improving patient outcomes, causing unnecessary anxiety and burden.
Question 7: As a part of the Universal Immunization Programme in India, the Inactivated Polio Vaccine (IPV) given as fractional IPV by intradermal route is first administered at what age?
- A. 14 weeks
- B. 9 months
- C. 6 weeks (Correct Answer)
- D. Birth
Explanation: ***6 weeks*** - In the Universal Immunization Programme (UIP) in India, the first dose of **fractional Inactivated Polio Vaccine (fIPV)** is administered to infants at **6 weeks of age** via the **intradermal route**. - This timing coordinates with other routine vaccinations given at 6 weeks, such as the first dose of the **pentavalent vaccine** (diphtheria, pertussis, tetanus, Hepatitis B, and Hib). *14 weeks* - The second dose of **fIPV** is typically administered at **14 weeks of age** within the UIP schedule. - This dose also aligns with other scheduled vaccinations at 14 weeks, reinforcing immunity against polio. *9 months* - At **9 months of age**, infants receive the first dose of **measles and rubella (MR) vaccine** and **Vitamin A supplementation** under the UIP. - No polio vaccine doses are scheduled at 9 months. *Birth* - At birth, infants are given the **oral polio vaccine (OPV0)**, **Hepatitis B birth dose**, and **Bacille Calmette-Guérin (BCG) vaccine**. - While initial polio immunization begins at birth, the **IPV is not administered at this stage**.
Question 8: Consider the following : 1. Intravenous tubes 2. Catheters 3. Gloves 4. Blood bags Which of the above-mentioned biomedical wastes will be segregated in Red bag as per the Biomedical Waste Management Rules, 2016?
- A. 2, 3 and 4
- B. 1, 3 and 4
- C. 1, 2 and 3
- D. 1, 2 and 4 (Correct Answer)
Explanation: ***1, 2 and 4*** - According to **Biomedical Waste Management Rules, 2016**, items like **intravenous tubes**, **catheters**, and **blood bags** are classified under **contaminated waste (recyclable)** and are collected in **red bags**. - These represent **plastic waste contaminated with blood/body fluids** that can be recycled after proper treatment. - **Note on gloves**: While contaminated gloves technically also fall under red bag category as per BMW Rules 2016, this question may be testing the most commonly cited examples, or referring to general examination gloves which may be less contaminated. *2, 3 and 4* - This option incorrectly includes **gloves** (Item 3) along with catheters and blood bags. - In the context of this question, gloves are not included in the expected answer, possibly because they may refer to general-purpose gloves with minimal contamination. *1, 3 and 4* - This combination incorrectly includes **gloves** (Item 3) along with IV tubes and blood bags. - While **intravenous tubes** and **blood bags** are correctly placed in red bags, the inclusion of gloves makes this an incorrect choice per the question's expected answer. *1, 2 and 3* - This option incorrectly includes **gloves** (Item 3) within the red bag category. - While **intravenous tubes** and **catheters** are appropriate for red bags due to contamination with body fluids, gloves are not included in the expected answer for this question.
Question 9: Which of the following is NOT required for calculating the Human Development Index? 1. Life expectancy at birth 2. Infant mortality rate 3. Gross national income per capita 4. Mean years of schooling
- A. Gross national income per capita
- B. Infant mortality rate (Correct Answer)
- C. Life expectancy at birth
- D. Mean years of schooling
Explanation: ***Infant mortality rate*** - The Human Development Index (HDI) focuses on broader measures of human well-being, specifically **health, education, and living standards**. - While reflecting a nation's health status, the **infant mortality rate** is not a direct component used in the HDI calculation. *Gross national income per capita* - **Gross national income (GNI) per capita** is a key component of the HDI, reflecting the **standard of living** dimension. - It measures the average income of a country's citizens and contributes to a country's overall development score. *Life expectancy at birth* - **Life expectancy at birth** is a crucial component of the HDI, representing the **health** dimension. - It indicates the average number of years a newborn infant can expect to live, given current mortality rates. *Mean years of schooling* - **Mean years of schooling** is a core component of the HDI, reflecting the **education** dimension. - It measures the average number of years of education received by people aged 25 and older.
Question 10: Which of the following statements regarding the Open Vial Policy, 2015 are correct? 1. It applies only for DPT, TT, Hepatitis B, OPV and Liquid Pentavalent vaccine. 2. Vaccine vials opened in session-site can be used again provided a vaccine vial monitor has not reached the discard point. 3. Open vial should never be submerged in water. 4. Open vials of BCG, Measles and JE should be preserved till the next immunization session.
- A. 4. Open vials of BCG, Measles and JE should be preserved till the next immunization session.
- B. 3. Open vial should never be submerged in water.
- C. 1. It applies only for DPT, TT, Hepatitis B, OPV and Liquid Pentavalent vaccine.
- D. 2. Vaccine vials opened in session-site can be used again provided a vaccine vial monitor has not reached the discard point. (Correct Answer)
Explanation: ***2. Vaccine vials opened in session-site can be used again provided a vaccine vial monitor has not reached the discard point.*** - The **Open Vial Policy, 2015**, permits the reuse of opened vials for specific vaccines if certain conditions are met, including the **Vaccine Vial Monitor (VVM)** indicating the vaccine is still potent. - This policy aims to reduce vaccine wastage while ensuring vaccine safety and efficacy. - This is the **core principle** of the Open Vial Policy and represents the primary objective of the policy. *3. Open vial should never be submerged in water.* - This statement is **CORRECT** according to the Open Vial Policy guidelines. - Vaccine vials should **never be submerged in water** as this can damage labels, obscure information, and increase the risk of contamination. - However, in the context of this question asking for the statement that best represents the Open Vial Policy, **Statement 2 is the better answer** as it directly addresses the core reuse principle. *4. Open vials of BCG, Measles and JE should be preserved till the next immunization session.* - **INCORRECT**: BCG, Measles, and JE vaccines are **reconstituted vaccines** that are sensitive to light and heat. - They must be **discarded within 4-6 hours** after reconstitution and **cannot be preserved** until the next immunization session due to rapid loss of potency and increased risk of contamination. - These vaccines are **explicitly excluded** from the Open Vial Policy. *1. It applies only for DPT, TT, Hepatitis B, OPV and Liquid Pentavalent vaccine.* - **INCORRECT**: The Open Vial Policy, 2015, specifically applies to **DPT, TT, Hepatitis B, OPV, liquid Pentavalent, Td, and Fractional IPV (fIPV) vaccines**. - This statement is incorrect because it uses the word "only" and **omits Td and fIPV** from the list of applicable vaccines.