Community Medicine
7 questionsWhich of the following is the most important modifiable risk factor for coronary heart disease?
Consider the phases of a family life cycle: 1. Contraction 2. Dissolution 3. Extension 4. Formation. What is the correct order of the phases from first to last?
Which of the following services are provided to pregnant women under the Integrated Child Development Scheme (ICDS)?
Which of the following are the principal causes of infant mortality in India? 1. Acute respiratory infections 2. Congenital anomalies 3. Childhood cancers 4. Diarrhoeal diseases
Throughout history, humans have been adapting environment to the genes more than adapting genes to the environment. Adapting environment to the genes is called
In a town, a study was carried out to determine the role of cigarette smoking in causation of lung cancer. It was found that a total of 7000 people in the town were smokers. Of them, 70 developed lung cancer. In the same town, 3000 people were non-smokers. Of them, 3 developed lung cancer. Given these numbers, what would be the attributable risk to cigarette smoking for lung cancer?
A town in the hills had a mid-year population of 250000 in the year 2021. During the same year, the death registry of the town recorded 1500 deaths due to tuberculosis in 365 calendar days. Given these facts, what is the specific death rate for tuberculosis in the town?
UPSC-CMS 2022 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following is the most important modifiable risk factor for coronary heart disease?
- A. Obesity
- B. Age
- C. Cigarette smoking (Correct Answer)
- D. Sedentary habits
Explanation: ***Cigarette smoking*** - **Cigarette smoking** is considered the most significant modifiable risk factor for coronary heart disease due to its direct and severe impact on **endothelial function** and **atherosclerosis**. - It causes vasoconstriction, increases **blood pressure**, lowers **HDL cholesterol**, and promotes **thrombosis**. *Obesity* - **Obesity** is a significant modifiable risk factor, often linked to other conditions like **hypertension** and **diabetes**, which increase CHD risk. - However, its impact is generally considered less direct and severe than that of active smoking. *Sedentary habits* - **Sedentary habits** contribute to CHD risk by promoting obesity, **insulin resistance**, and unfavorable lipid profiles. - While important, the direct and immediate harm caused by sedentary habits is typically less pronounced compared to smoking. *Age* - **Age** is a major risk factor for coronary heart disease, with risk increasing significantly as one gets older. - However, age is a **non-modifiable** risk factor, meaning it cannot be changed, unlike the factors listed in the other options.
Question 102: Consider the phases of a family life cycle: 1. Contraction 2. Dissolution 3. Extension 4. Formation. What is the correct order of the phases from first to last?
- A. 2 → 1 → 3 → 4
- B. 1 → 2 → 3 → 4
- C. 1 → 3 → 1 → 2
- D. 4 → 3 → 1 → 2 (Correct Answer)
Explanation: ***4 → 3 → 1 → 2*** - The family life cycle typically begins with **formation** (union of individuals), followed by **extension** (addition of members like children). - It then moves to **contraction** (children leaving home) and finally **dissolution** (death of one or both parents). *2 → 1 → 3 → 4* - This order places **dissolution** and **contraction** before **formation** and **extension**, which is incorrect as it reverses the natural progression of family development. - The family unit must first be formed and grow before it can contract or dissolve. *1 → 2 → 3 → 4* - This sequence begins with **contraction**, implying the family is already shrinking before it has fully formed or extended, which goes against the established phases of family life. - It inaccurately places **extension** at a later stage after contraction and dissolution have supposedly begun. *1 → 3 → 1 → 2* - This option incorrectly repeats **contraction** and does not include the initial **formation** phase, making it an incomplete and misordered representation of the family life cycle. - The sequence is illogical as it suggests repeated contraction without a clear beginning or end.
Question 103: Which of the following services are provided to pregnant women under the Integrated Child Development Scheme (ICDS)?
- A. Health check-up
- B. Nutrition and health education
- C. Immunization against tetanus
- D. Supplementary nutrition (Correct Answer)
Explanation: ***Supplementary nutrition*** - **Supplementary nutrition** is the most direct and primary tangible service provided under ICDS specifically targeting pregnant women as beneficiaries. - Under ICDS, pregnant women receive **300 calories and 10-12 grams of protein** for at least 90 days during pregnancy to bridge the calorie and protein gap in their diets. - This is a core service directly provided at Anganwadi centers, ensuring better health outcomes for both mother and developing fetus. - Among all ICDS services for pregnant women, supplementary nutrition is the **most distinctive and substantial direct benefit** that pregnant women receive. *Health check-up* - While health check-ups are part of ICDS package services, they are primarily conducted by ANMs and medical officers from the health system. - Anganwadi Workers facilitate identification, weight monitoring, and referrals, but the comprehensive health examinations are delivered through convergence with the health department rather than as a direct standalone ICDS service. *Nutrition and health education* - Nutrition and health education is indeed provided under ICDS to pregnant women and mothers. - However, it is an **enabling/educational service** rather than a direct tangible provision like supplementary nutrition. - The question likely seeks the most characteristic direct service, which is supplementary nutrition. *Immunization against tetanus* - Immunization services including tetanus toxoid are part of the integrated ICDS-health system approach. - However, vaccines are administered by health workers (ANMs), not by Anganwadi Workers themselves. - ICDS role is primarily facilitative through awareness generation and referral linkages to health facilities.
Question 104: Which of the following are the principal causes of infant mortality in India? 1. Acute respiratory infections 2. Congenital anomalies 3. Childhood cancers 4. Diarrhoeal diseases
- A. 2, 3 and 4
- B. 1, 2 and 4 (Correct Answer)
- C. 1, 2 and 3
- D. 1, 3 and 4
Explanation: ***1, 2 and 4*** - **Acute respiratory infections (ARIs)** and **diarrhoeal diseases** are major contributors due to prevalent infections and inadequate sanitation. - **Congenital anomalies** represent a significant cause, indicating the importance of prenatal care and early diagnosis. *2, 3 and 4* - This option incorrectly includes **childhood cancers** as a principal cause. While tragic, **childhood cancers** contribute to a smaller proportion of infant deaths compared to infectious diseases and congenital issues in India. - **Acute respiratory infections** are a critical component of infant mortality, and their exclusion makes this option incomplete. *1, 2 and 3* - This option incorrectly excludes **diarrhoeal diseases**, which are a leading cause of infant mortality in India due to factors like poor hygiene and contaminated water. - While **acute respiratory infections** and **congenital anomalies** are key, the omission of diarrhoeal diseases makes this answer incomplete. *1, 3 and 4* - This option incorrectly includes **childhood cancers** as a principal cause of infant mortality. - It also omits **congenital anomalies**, which are a significant and well-documented cause of infant deaths in India.
Question 105: Throughout history, humans have been adapting environment to the genes more than adapting genes to the environment. Adapting environment to the genes is called
- A. euthenics (Correct Answer)
- B. euphenics
- C. eugenics
- D. acculturation
Explanation: ***Euthenics*** - **Euthenics** is the study of improving human functioning and well-being by improving **environmental conditions**. - This concept focuses on **adapting the environment** (e.g., nutrition, sanitation, housing) to suit existing human genetic predispositions. *Euphenics* - **Euphenics** involves improving human characteristics through the **alteration of the genes** or treating conditions that arise from genetic defects. - This field includes interventions like **gene therapy** or medical treatments to counteract genetic disorders. *Eugenics* - **Eugenics** is a set of beliefs and practices aiming to **improve the genetic quality** of the human population, typically by encouraging reproduction among those with "desirable" traits and discouraging it among those with "undesirable" traits. - Historically, it has been associated with **socially coercive policies** and is now largely discredited due to its unethical implications. *Acculturation* - **Acculturation** is the process of cultural and psychological change that results from contact between different cultures, leading to the **adoption of new cultural traits**. - It describes changes individuals or groups undergo when exposed to a new culture, not the direct manipulation of genes or environment for genetic improvement.
Question 106: In a town, a study was carried out to determine the role of cigarette smoking in causation of lung cancer. It was found that a total of 7000 people in the town were smokers. Of them, 70 developed lung cancer. In the same town, 3000 people were non-smokers. Of them, 3 developed lung cancer. Given these numbers, what would be the attributable risk to cigarette smoking for lung cancer?
- A. 30%
- B. 10%
- C. 60%
- D. 90% (Correct Answer)
Explanation: **90%** - The **attributable risk** (AR) is calculated as the incidence in the exposed group minus the incidence in the unexposed group, divided by the incidence in the exposed group, all multiplied by 100%. - Incidence in smokers (Ie) = 70 cases / 7000 smokers = 0.01. Incidence in nonsmokers (Io) = 3 cases / 3000 nonsmokers = 0.001. AR = ((0.01 - 0.001) / 0.01) * 100% = (0.009 / 0.01) * 100% = 0.9 * 100% = **90%**. *30%* - This percentage is incorrect; it does not align with the formal calculation of **attributable risk** based on the given incidence rates in exposed and unexposed groups. - A value of 30% would imply a much smaller difference in incidence between smokers and non-smokers relative to the incidence in smokers. *10%* - This value might be obtained if the calculation confused **attributable risk** with the proportion of cases in the unexposed group or some other miscalculation. - It significantly underestimates the proportion of lung cancer in smokers directly attributable to their smoking status. *60%* - This answer is incorrect as it does not result from the appropriate application of the **attributable risk formula**. - The discrepancy between the incidence rate in smokers (0.01) and non-smokers (0.001) is much higher than what would lead to a 60% attributable risk.
Question 107: A town in the hills had a mid-year population of 250000 in the year 2021. During the same year, the death registry of the town recorded 1500 deaths due to tuberculosis in 365 calendar days. Given these facts, what is the specific death rate for tuberculosis in the town?
- A. 10
- B. 60
- C. 1
- D. 6 (Correct Answer)
Explanation: ***6*** - The **specific death rate** (also called cause-specific death rate) is calculated as **(Number of deaths from a specific cause / Mid-year population) × 1000** - For tuberculosis: (1500 deaths / 250,000 population) × 1000 = **6 deaths per 1000 population** - This represents the tuberculosis mortality rate in the community *10* - This incorrect value would be obtained if there were 2500 deaths due to tuberculosis instead of 1500 - Calculation error: (2500 / 250,000) × 1000 = 10 - Always verify the numerator (number of deaths) from the given data *60* - This is a common calculation error resulting from incorrect multiplication factor - May occur if using: (1500 / 250,000) × 10,000 = 60 (wrong multiplier) - Remember: specific death rate uses **per 1000** population, not per 10,000 *1* - This value results from calculation errors or incorrect rounding - May occur if dividing by wrong population figure or forgetting the multiplier - The actual rate (1500/250,000 = 0.006) must be multiplied by 1000 to get rate per 1000 population
Obstetrics and Gynecology
1 questionsDetermination of alpha-fetoprotein levels in maternal serum is a useful screening tool for
UPSC-CMS 2022 - Obstetrics and Gynecology UPSC-CMS Practice Questions and MCQs
Question 101: Determination of alpha-fetoprotein levels in maternal serum is a useful screening tool for
- A. Duchenne muscular dystrophy
- B. phenylketonuria
- C. congenital hypothyroidism
- D. neural tube defects (Correct Answer)
Explanation: ***Correct: neural tube defects*** - Elevated maternal serum **alpha-fetoprotein (AFP)** is a key indicator for open **neural tube defects** because the fetal tissue leaks AFP into the amniotic fluid and then into the maternal circulation. - This screening tool is sensitive enough to detect conditions like **spina bifida** and **anencephaly**. - Typically performed at **15-20 weeks gestation** as part of the triple or quad screen. *Incorrect: Duchenne muscular dystrophy* - This is a **genetically inherited X-linked recessive disorder** primarily diagnosed through genetic testing or muscle biopsy, not maternal serum AFP levels. - While **creatine kinase (CK)** levels can be elevated in affected individuals, it is not a prenatal AFP screening target. *Incorrect: phenylketonuria* - **Phenylketonuria (PKU)** is an inborn error of metabolism, typically screened for postnatally using a **newborn heel prick test** to detect elevated phenylalanine levels. - Maternal serum AFP is not used for its detection; the condition is managed by a special diet. *Incorrect: congenital hypothyroidism* - **Congenital hypothyroidism** is identified through **newborn screening programs** that measure levels of **thyroid-stimulating hormone (TSH)** or **thyroxine (T4)** from a heel prick. - Maternal serum AFP has no role in the screening or diagnosis of this condition.
Pharmacology
2 questionsWhich of the following is a rare vaccine reaction known to occur with BCG vaccine in immunocompetent individuals?
Which one of the following vaccines is known to interfere with the Yellow Fever vaccine if administered within 3 weeks of each other?
UPSC-CMS 2022 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following is a rare vaccine reaction known to occur with BCG vaccine in immunocompetent individuals?
- A. Guillain-Barre syndrome
- B. Osteitis (Correct Answer)
- C. Suppurative lymphadenitis
- D. Disseminated infection
Explanation: ***Osteitis*** - **Osteitis** (inflammation of bone) is a **rare complication** of the BCG vaccine, occurring in **immunocompetent individuals**, particularly infants. - Incidence: approximately **1-30 cases per million doses**. - It results from the **dissemination of live attenuated *Mycobacterium bovis*** (the strain used in BCG) to bone tissue. - Typically presents months after vaccination with localized bone pain and swelling. *Guillain-Barré syndrome* - **Guillain-Barré syndrome** is a rare neurological disorder characterized by rapid-onset muscle weakness. - While it can be triggered by various infections and, rarely, by some vaccines (e.g., influenza vaccine), it is **not specifically associated with the BCG vaccine**. *Suppurative lymphadenitis* - **Suppurative lymphadenitis** (inflammation and pus formation in lymph nodes) is a **relatively common adverse reaction** to the BCG vaccine, not a rare one. - Incidence: **0.01-4.3%** of vaccinees. - It typically occurs in regional lymph nodes draining the injection site and usually resolves with conservative management or needle aspiration. *Disseminated infection* - **Disseminated BCG infection** is an **extremely rare** complication (0.06-1.56 per million doses). - It occurs **primarily in immunocompromised individuals** (e.g., severe combined immunodeficiency, HIV). - This is a contraindication-related complication rather than a typical vaccine reaction in the general population. - The question specifies immunocompetent individuals, making **osteitis** the most appropriate answer as it represents the classic rare complication in normal hosts.
Question 102: Which one of the following vaccines is known to interfere with the Yellow Fever vaccine if administered within 3 weeks of each other?
- A. Tetanus toxoid
- B. Cholera vaccine
- C. Typhoid vaccine
- D. Measles vaccine (Correct Answer)
Explanation: ***Correct: Measles vaccine*** - **Measles vaccine (MMR)** is a **live attenuated viral vaccine** that can interfere with yellow fever vaccine immune response - Both are live viral vaccines and CDC/WHO guidelines recommend they be administered **simultaneously OR separated by ≥4 weeks** - When live viral vaccines are given too close together (but not simultaneously), immune interference can reduce antibody response to the second vaccine - This is due to **interferon production** from the first vaccine suppressing replication of the second vaccine virus *Incorrect: Typhoid vaccine* - While **oral typhoid vaccine (Ty21a)** is live attenuated, it is a **bacterial vaccine** and does not have the same viral interference pattern - Can generally be co-administered with yellow fever vaccine without significant spacing requirements - Main concern with oral typhoid is interference from **antibiotics and antimalarials**, not other vaccines *Incorrect: Tetanus toxoid* - **Inactivated vaccine** that does not interfere with live vaccines - Can be given simultaneously or at any interval with yellow fever vaccine - No immune competition with live viral vaccines *Incorrect: Cholera vaccine* - Currently available **oral cholera vaccines** (CVD 103-HgR or killed whole-cell vaccines) do not have documented interference with yellow fever - No specific spacing requirements with yellow fever vaccine - Can be co-administered or given at any interval **Note:** This question is from UPSC-CMS 2022. The original exam key may have listed typhoid, but current CDC and WHO immunization guidelines identify measles (MMR) as the primary vaccine requiring spacing with yellow fever due to live viral vaccine interference.