Water contamination with which chemical can lead to methaemoglobinaemia?
Q32
With reference to occupational cancers, consider the following statements :
1. Skin cancer is a common occupational hazard in workers employed in nickel and chromium work.
2. Cancer bladder is an occupational hazard in workers employed in dye-stuffs and dyeing industry.
3. Leukaemia can occur on long exposure to benzol.
4. Lung cancer is typically found in workers employed in electric cable industries. Which of the statements given above are correct ?
Q33
Which of the following are beneficiaries of services provided under the Integrated Child Development Scheme (ICDS) ?
1. Adolescent boys
2. Adolescent girls
3. Pregnant women
4. Children less than 6 years of age
Select the correct answer using the code given below :
Q34
Which of the following correctly represent the critical determinants of a healthy facility being declared as a First Referral Unit (FRU) ?
1. Availability of emergency obstetric surgical interventions
2. Availability of immunization services
3. Blood storage facility
4. Newborn care
Select the correct answer using the code given below :
Q35
What is the correct increasing order of minimum age at which the following vaccines are administered to a child, as part of the National Immunization Schedule (NIS) after birth of child ?
1. BCG vaccine
2. Japanese Encephalitis (JE) vaccine
3. Rotavirus vaccine
4. Tetanus and adult diphtheria (Td) vaccine
Select the correct answer using the code given below :
Q36
Under the National Leprosy Eradication Programme, ASHAs have been entrusted to which of the following activities ?
1. ASHAs are to search for suspected cases of leprosy in their villages and take them to the PHCs for diagnosis and treatment.
2. ASHAs arrange an amount of ₹ 5,000 as an incentive to each leprosy affected person in their village for undergoing reconstructive surgery.
3. ASHAs ensure that each leprosy affected person in their village receives micro-cellular rubber footwear for protection of insensitive feet.
4. ASHAs follow up all confirmed cases of leprosy in their village to ensure their treatment completion.
Select the correct answer using the code given below :
Q37
The cost of implementation of 'Ayushman Bharat Pradhan Mantri Jan Arogya Yojana' is borne by :
Q38
All of the following are dashboard indicators used for monitoring of India Newborn Action Plan (INAP). Which one of them is an impact level indicator ?
Q39
Which of the following are health education models ?
1. Medical model
2. Motivation model
3. Persuasion model
4. Social intervention model
Select the correct answer using the code given below :
Q40
Consider the following statements about correlation between two variables :
1. The correlation is done between an independent variable X and a dependent variable Y.
2. The coefficient of correlation can range from -1 to ∞.
3. If coefficient of correlation (r) is equal to 1, it indicates there is no association between X and Y.
4. Correlation does not necessarily prove causation. Which of the statements given above are correct ?
UPSC-CMS 2023 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 31: Water contamination with which chemical can lead to methaemoglobinaemia?
A. Sulphide
B. Nitrate (Correct Answer)
C. Fluoride
D. Cyanide
Explanation: ***Nitrate***
- **Nitrate** compounds in contaminated water can be reduced to **nitrites** in the gastrointestinal tract, especially in infants.
- **Nitrites** oxidize the iron in **hemoglobin** from the ferrous (Fe2+) to the ferric (Fe3+) state, forming **methaemoglobin**, which cannot bind oxygen.
*Sulphide*
- **Sulphide** (e.g., hydrogen sulfide) poisoning primarily affects the **respiratory and nervous systems** by inhibiting cytochrome c oxidase.
- It does not directly cause the formation of **methaemoglobin** as its primary mechanism of toxicity.
*Fluoride*
- **Fluoride** contamination is primarily associated with **dental fluorosis** (mottling of teeth) and **skeletal fluorosis** (bone and joint pain, brittle bones).
- It does not directly induce **methaemoglobinaemia** as its main toxicological effect.
*Cyanide*
- **Cyanide** poisoning acts by inhibiting **cytochrome c oxidase** in the mitochondrial electron transport chain, leading to cellular hypoxia.
- While it can impair oxygen utilization, it does not primarily cause **methaemoglobinaemia** by oxidizing hemoglobin.
Question 32: With reference to occupational cancers, consider the following statements :
1. Skin cancer is a common occupational hazard in workers employed in nickel and chromium work.
2. Cancer bladder is an occupational hazard in workers employed in dye-stuffs and dyeing industry.
3. Leukaemia can occur on long exposure to benzol.
4. Lung cancer is typically found in workers employed in electric cable industries. Which of the statements given above are correct ?
A. 1, 2 and 3 only (Correct Answer)
B. 1 and 2 only
C. 2 and 3 only
D. 1 and 4 only
Explanation: ***1, 2 and 3 only***
- **Skin cancer** is a well-documented occupational hazard for workers exposed to compounds like **nickel and chromium**, which are known **carcinogens**.
- **Bladder cancer** is strongly linked to exposure to aromatic amines found in **dye-stuffs and the dyeing industry**.
- **Leukaemia** is a known risk associated with prolonged exposure to **benzene (benzol)**, a common industrial solvent.
*1 and 2 only*
- This option is incomplete as it correctly identifies the link between **skin cancer** and nickel/chromium exposure, and **bladder cancer** and dye-stuffs, but it omits the correct association of **leukaemia** with benzene exposure.
- The statement regarding **lung cancer** in electric cable industries is generally incorrect, as lung cancer is typically associated with other occupational exposures like **asbestos** or **radon**.
*2 and 3 only*
- While statements 2 and 3 are correct regarding **bladder cancer** in dye industries and **leukaemia** from benzene, this option incorrectly excludes the statement about **skin cancer** in nickel and chromium work, which is also accurate.
- It does not encompass all the correct occupational cancer associations presented.
*1 and 4 only*
- This option includes the correct association of **skin cancer** with nickel and chromium.
- However, the statement regarding **lung cancer** in workers employed in electric cable industries is generally **false**, as this industry is not typically associated with a high incidence of lung cancer compared to other occupational carcinogens.
Question 33: Which of the following are beneficiaries of services provided under the Integrated Child Development Scheme (ICDS) ?
1. Adolescent boys
2. Adolescent girls
3. Pregnant women
4. Children less than 6 years of age
Select the correct answer using the code given below :
A. 2, 3 and 4 (Correct Answer)
B. 1, 2 and 3
C. 1, 3 and 4
D. 1, 2 and 4
Explanation: ***2, 3 and 4***
- The **Integrated Child Development Services (ICDS)** scheme specifically targets **adolescent girls (11-14 years)**, **pregnant women**, and **children under 6 years of age** as primary beneficiaries.
- Services include **supplementary nutrition**, **immunization**, **health check-ups**, **referral services**, **nutrition and health education**, and **pre-school education**.
- Adolescent girls were included through the **Scheme for Adolescent Girls (SAG)** to address their nutritional and health needs during the critical growth phase.
*1, 2 and 3*
- Incorrectly includes **adolescent boys**, who are not primary beneficiaries of ICDS.
- The scheme focuses on vulnerable groups with specific nutritional and reproductive health needs.
*1, 3 and 4*
- Incorrectly includes **adolescent boys** while excluding **adolescent girls**.
- Omits **pregnant women**, who are a core beneficiary group receiving antenatal care and nutritional support.
*1, 2 and 4*
- Incorrectly includes **adolescent boys**.
- Omits **pregnant women**, who receive crucial services including antenatal care, nutritional supplementation, and health education through ICDS.
Question 34: Which of the following correctly represent the critical determinants of a healthy facility being declared as a First Referral Unit (FRU) ?
1. Availability of emergency obstetric surgical interventions
2. Availability of immunization services
3. Blood storage facility
4. Newborn care
Select the correct answer using the code given below :
A. 1, 2 and 3
B. 1, 3 and 4 (Correct Answer)
C. 1, 2 and 4
D. 2, 3 and 4
Explanation: ***1, 3 and 4***
- A **First Referral Unit (FRU)** is a health facility equipped to provide basic and comprehensive essential obstetric and newborn care services, including **emergency obstetric surgical interventions** (like C-sections), a **blood storage facility**, and comprehensive **newborn care**.
- These components are crucial for managing obstetric emergencies and ensuring the survival of mothers and newborns, which defines the core function of an FRU.
*1, 2 and 3*
- While immunization services are important for public health, they are not a critical determinant for classifying a facility specifically as a **First Referral Unit (FRU)**, which focuses on emergency obstetric and newborn care.
- The absence of comprehensive newborn care as a listed determinant makes this option incomplete for FRU criteria.
*1, 2 and 4*
- This option misses the critical determinant of having a **blood storage facility**, which is essential for managing obstetric hemorrhages and is a core requirement for an FRU.
- Again, **immunization services** are not a primary defining characteristic of an FRU.
*2, 3 and 4*
- This option incorrectly includes **immunization services** as a critical determinant while omitting **emergency obstetric surgical interventions**, which are fundamental to an FRU's ability to handle life-threatening situations during childbirth.
- An FRU must be capable of performing C-sections and other emergency surgeries.
Question 35: What is the correct increasing order of minimum age at which the following vaccines are administered to a child, as part of the National Immunization Schedule (NIS) after birth of child ?
1. BCG vaccine
2. Japanese Encephalitis (JE) vaccine
3. Rotavirus vaccine
4. Tetanus and adult diphtheria (Td) vaccine
Select the correct answer using the code given below :
A. 1→2→3→4
B. 1→3→2→4 (Correct Answer)
C. 2→3→1→4
D. 3→1→4→2
Explanation: **1→3→2→4**
- This order reflects the standard schedule of vaccine administration in the **National Immunization Schedule (NIS)**, starting with vaccines given at birth or shortly after, followed by those administered in late infancy and early childhood, and finally those for adolescents.
- The correct sequence is: **BCG at birth**, **Rotavirus at 6 weeks**, **Japanese Encephalitis at 9 months**, and **Td at 10 and 16 years**.
*1→2→3→4*
- This option incorrectly places the **Japanese Encephalitis (JE) vaccine** before the **Rotavirus vaccine**. The Rotavirus vaccine is typically given at 6 weeks, while JE is given later at 9 months.
- The sequence of **JE** and **Rotavirus** is inverted compared to the NIS guidelines.
*2→3→1→4*
- This order is incorrect because it places the **BCG vaccine** after both the **Japanese Encephalitis (JE) vaccine** and the **Rotavirus vaccine**, even though BCG is administered at birth.
- The early administration of **BCG** at birth is a fundamental aspect of the immunization schedule, making this sequence incorrect.
*3→1→4→2*
- This option incorrectly places the **Rotavirus vaccine** as the earliest, ahead of the **BCG vaccine**, which is given at birth or very soon after.
- It also incorrectly places the **Td vaccine** before the **Japanese Encephalitis (JE) vaccine**, as JE is given at 9 months and Td later, in adolescence.
Question 36: Under the National Leprosy Eradication Programme, ASHAs have been entrusted to which of the following activities ?
1. ASHAs are to search for suspected cases of leprosy in their villages and take them to the PHCs for diagnosis and treatment.
2. ASHAs arrange an amount of ₹ 5,000 as an incentive to each leprosy affected person in their village for undergoing reconstructive surgery.
3. ASHAs ensure that each leprosy affected person in their village receives micro-cellular rubber footwear for protection of insensitive feet.
4. ASHAs follow up all confirmed cases of leprosy in their village to ensure their treatment completion.
Select the correct answer using the code given below :
A. 2 and 3 only
B. 1 and 2 only
C. 1 and 4 only (Correct Answer)
D. 3 and 4 only
Explanation: ***1 and 4 only***
- ASHAs are actively involved in **community-based surveillance**, including **searching for suspected cases of leprosy** in their villages and referring them to Primary Health Centers (PHCs) for diagnosis and treatment.
- They also play a crucial role in ensuring **treatment adherence** by following up on all confirmed cases to ensure **treatment completion**, which is vital for leprosy eradication.
*2 and 3 only*
- While ASHAs facilitate access to services, their role does not directly include arranging **incentive payments** for reconstructive surgery or directly providing **micro-cellular rubber footwear**. These services are typically handled by other program components or higher levels of the healthcare system.
- ASHAs primarily focus on **case detection, referral, and treatment supervision**, not direct financial or material provision for reconstructive surgery incentives or specialized footwear.
*1 and 2 only*
- ASHAs are indeed involved in **case detection and referral (statement 1)**.
- However, they are **not responsible for arranging direct incentive payments (statement 2)** for reconstructive surgery; this falls outside their designated activities within the National Leprosy Eradication Programme.
*3 and 4 only*
- ASHAs are primarily involved in **follow-up for treatment completion (statement 4)**.
- However, their role does not include directly **providing micro-cellular rubber footwear (statement 3)**; this is usually provided through other channels within the healthcare system to support prevention of disabilities.
Question 37: The cost of implementation of 'Ayushman Bharat Pradhan Mantri Jan Arogya Yojana' is borne by :
A. State Government only
B. Private institutions only as a part of their Corporate Social Responsibility
C. Both Central Government and State Government (Correct Answer)
D. Central Government only
Explanation: ***Both Central Government and State Government***
- The **Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)** is a centrally sponsored scheme, meaning its funding is shared between the **Central Government** and participating **State Governments**.
- The funding mechanism generally follows a ratio, for instance, a 60:40 split between the Centre and States, though this can vary for special category states.
*State Government only*
- If the scheme were solely funded by the state government, it would be a state scheme, not a **centrally sponsored national health protection scheme**.
- The scale and ambition of AB PM-JAY require significant central government contributions to ensure **uniform implementation** and coverage across India.
*Private institutions only as a part of their Corporate Social Responsibility*
- While private institutions may engage in healthcare initiatives through **Corporate Social Responsibility (CSR)**, AB PM-JAY is a government-funded scheme.
- The primary financial responsibility for this large-scale health insurance program rests with the **government bodies**, not private entities via CSR.
*Central Government only*
- While the **Central Government** provides a substantial portion of the funding, this scheme is not fully funded by the Centre.
- State governments are required to contribute their share, underscoring the **collaborative federal structure** of its financing and implementation.
Question 38: All of the following are dashboard indicators used for monitoring of India Newborn Action Plan (INAP). Which one of them is an impact level indicator ?
A. Neonatal mortality rate (Correct Answer)
B. Caesarean section rate
C. Percentage of preterm births
D. Exclusive breastfeeding rate
Explanation: ***Neonatal mortality rate***
- This is a key **impact indicator** because it directly measures the ultimate outcome of newborn health interventions: the reduction of deaths in the neonatal period.
- Changes in the neonatal mortality rate reflect the overall effectiveness of programs aimed at improving newborn survival.
*Caesarean section rate*
- This is typically an **outcome or process indicator**, reflecting healthcare service delivery and utilization rather than the direct impact on newborn survival.
- While relevant to maternal and newborn health, it doesn't directly measure newborn mortality or morbidity as an outcome.
*Percentage of preterm births*
- This is an **intermediate outcome indicator** or a **risk factor indicator**, as preterm birth is a major cause of neonatal mortality and morbidity.
- While crucial for monitoring, it is a determinant of neonatal mortality rather than the direct impact itself.
*Exclusive breastfeeding rate*
- This is generally a **process indicator** or a **behavioral indicator**, reflecting the adoption of a recommended practice that supports newborn health.
- While exclusive breastfeeding positively impacts newborn survival, the rate itself is not an impact measure of mortality reduction.
Question 39: Which of the following are health education models ?
1. Medical model
2. Motivation model
3. Persuasion model
4. Social intervention model
Select the correct answer using the code given below :
A. 1, 3 and 4
B. 1, 2 and 3 (Correct Answer)
C. 2, 3 and 4
D. 1, 2 and 4
Explanation: ***1, 2 and 3***
- The **Medical model**, **Educational/Motivation model**, and **Persuasion model** are considered the three classical/traditional health education models in standard community medicine classification.
- **Medical Model**: Focuses on medical information dissemination and disease prevention through expert-driven interventions.
- **Educational/Motivation Model**: Emphasizes voluntary behavior change through information, education, and personal motivation.
- **Persuasion Model**: Uses persuasive communication techniques and social marketing to influence health behaviors.
- According to the classification used in this examination context, these three constitute the primary health education models.
*1, 3 and 4*
- While the **Medical model** and **Persuasion model** are classical health education models, the **Social Intervention Model** represents a broader, more contemporary approach.
- The Social Intervention Model (also called Social Change Model) focuses on modifying social structures, policies, and environmental factors rather than primarily targeting individual behavior change.
- In traditional classifications, it may be categorized separately from the three classical individual-focused models.
*2, 3 and 4*
- The **Educational/Motivation model** and **Persuasion model** are recognized classical health education models.
- However, based on traditional classification systems, the **Social Intervention Model** is sometimes distinguished as a macro-level societal approach rather than grouped with individual-focused health education models.
*1, 2 and 4*
- The **Medical model** and **Educational/Motivation model** are established classical health education models.
- The **Social Intervention Model**, while important in modern public health practice, represents a different paradigm focusing on community-wide and policy-level changes rather than the individual/group education focus of classical models.
- Traditional health education frameworks distinguish between individual behavior change models (options 1, 2, 3) and broader social change approaches (option 4).
Question 40: Consider the following statements about correlation between two variables :
1. The correlation is done between an independent variable X and a dependent variable Y.
2. The coefficient of correlation can range from -1 to ∞.
3. If coefficient of correlation (r) is equal to 1, it indicates there is no association between X and Y.
4. Correlation does not necessarily prove causation. Which of the statements given above are correct ?
A. 1 only
B. 4 only (Correct Answer)
C. 1, 2 and 3
D. 1 and 4 only
Explanation: ***Correct: 4 only***
- **Correlation** measures the strength and direction of a linear relationship between two variables, but it **does not imply that one causes the other**; other factors or confounding variables might be involved.
- This statement is a fundamental principle in statistics, emphasizing that causality requires more rigorous evidence, such as controlled experiments, beyond a simple correlation.
- **Only statement 4 is correct** among all the given statements.
*Incorrect: 1 only*
- While correlation is often explored between dependent and independent variables, it can also be used to assess the relationship between **any two quantitative variables**, whether one is clearly designated as independent or dependent.
- Statement 1 is partially incorrect as correlation isn't exclusively between designated independent and dependent variables.
*Incorrect: 1, 2 and 3*
- Statement 1 is partially incorrect as correlation isn't exclusively between designated independent and dependent variables.
- Statement 2 is incorrect because the **coefficient of correlation (r) ranges from -1 to +1**, not to infinity, with -1 indicating a perfect negative correlation and +1 a perfect positive correlation.
- Statement 3 is incorrect because an **r equal to 1 indicates a perfect positive linear association** between X and Y, meaning they move in the same direction proportionally, not no association.
*Incorrect: 1 and 4 only*
- Statement 1 is incorrect because **correlation can be performed between any two variables** to assess their relationship, not just an explicitly independent and dependent pair.
- While statement 4 is correct, the inclusion of statement 1 makes this option incorrect.