UPSC-CMS 2023 Practice Questions

Q: Which food proteins among the following are considered to be the best and are used in nutritional studies as 'reference protein' ?

Egg proteins. ***Egg proteins*** - **Egg proteins** provide all **essential amino acids** in proportions that closely match human requirements, making them a **high-quality protein**. - Due to their excellent amino acid profile and high digestibility, **egg proteins** are often used as a **reference protein** in nutritional studies to evaluate the biological value of other proteins. *Milk proteins* - While **milk proteins** (casein and whey) are generally considered high-quality, their amino acid profile is not as perfectly balanced for human needs as egg protein. - They are commonly used as a reference for assessing protein quality, but **egg protein** often serves as the gold standard for comparison. *Legume proteins* - **Legume proteins** are typically deficient in **methionine and cysteine**, essential amino acids, making them an incomplete protein when consumed alone. - Their overall **biological value** is lower than animal proteins, and they are not considered a reference protein. *Wheat proteins* - **Wheat proteins** (gluten) are deficient in the **essential amino acid lysine**. - They have a lower **biological value** and are not as easily digestible as animal proteins, thus not suitable as a reference protein.

Q: Consider the following statements with reference to 'trans fatty acids' : 1. They are geometrical isomers of cis-unsaturated fatty acids. 2. Though atherogenic, being unsaturated they are less so than saturated fatty acids. 3. It takes years for trans fatty acids to be flushed from the body. 4. They lower both LDL cholesterol and HDL cholesterol in the body. Which of the statements given above are correct ?

1 only. ***1 only*** - **Statement 1 is CORRECT**: Trans fatty acids are **geometrical isomers of cis-unsaturated fatty acids**, differing in the spatial arrangement of hydrogen atoms around the carbon-carbon double bond. This structural difference gives them physical and biological properties more similar to saturated fats. - **Statement 2 is INCORRECT**: Trans fatty acids are **MORE atherogenic** than saturated fatty acids, not less. They raise LDL cholesterol and lower HDL cholesterol more significantly than saturated fats. - **Statement 3 is INCORRECT**: Trans fatty acids are metabolized and eliminated from the body within **days to weeks**, not years. Long-term cardiovascular damage results from chronic dietary exposure, not slow elimination kinetics. - **Statement 4 is INCORRECT**: Trans fatty acids **raise LDL cholesterol** ("bad" cholesterol) and **lower HDL cholesterol** ("good" cholesterol). They do not lower both as stated. *1 and 3 only* - Statement 1 is correct, but statement 3 is **incorrect**. The body processes and eliminates trans fatty acids relatively quickly (days to weeks), not years. The detrimental cardiovascular effects accumulate due to chronic dietary exposure, not slow metabolism of individual molecules. *2, 3 and 4* - All three statements are **incorrect**. Statement 2 is wrong because trans fats are **more atherogenic** than saturated fats. Statement 3 is wrong because trans fats are metabolized within weeks, not years. Statement 4 is wrong because trans fats **raise LDL** (not lower it) while lowering HDL. *1, 3 and 4* - Only statement 1 is correct. Statement 3 is **incorrect** as trans fatty acids are metabolized within weeks, not years. Statement 4 is **incorrect** because trans fatty acids **increase LDL cholesterol** and **decrease HDL cholesterol** - they do not lower both.

Q: Regarding active immunization against Typhoid fever, consider the following statements : 1. The typhoid polysaccharide vaccine is injectable and can be given subcutaneously or intramuscularly. 2. The typhoid polysaccharide vaccine is required to be given in two doses and administered on 0 and 7th day. 3. The typhoid oral Ty21a vaccine requires to be given in three doses on 0, 3rd and 7th days. 4. Protective immunity with typhoid vaccines is achieved immediately after the vaccine is received. Which of the statements given above is/are correct ?

1 only. ***1 only*** - The **typhoid polysaccharide vaccine** (ViCPS vaccine) is an **injectable vaccine**, typically administered **intramuscularly**. While subcutaneous administration might occur in specific situations, intramuscular is the standard route. - This statement accurately describes the general nature and administration route of the typhoid polysaccharide vaccine. *2 and 3 only* - The **typhoid polysaccharide vaccine (ViCPS) is usually given as a single dose** for primary immunization, not two doses on day 0 and 7. Boosters may be given every 2-3 years. - The **oral Ty21a vaccine requires three or four doses** (depending on the formulation and guidelines) taken on alternate days, typically on days 1, 3, and 5 (for a 3-dose regimen) or 1, 3, 5, and 7 (for a 4-dose regimen), not specifically on days 0, 3rd, and 7th. *1 and 2 only* - As explained, Statement 2 is incorrect because the **typhoid polysaccharide vaccine is generally a single-dose vaccine** for initial immunization. - Therefore, this option containing an incorrect statement cannot be the correct answer. *1, 3 and 4* - Statement 3 is incorrect as the **oral Ty21a vaccine dosing schedule is typically on alternate days** (e.g., 1, 3, 5 or 1, 3, 5, 7), not specifically 0, 3rd, and 7th. - Statement 4 is incorrect because **protective immunity from typhoid vaccines is not achieved immediately**; it takes about 1-2 weeks for the immune system to develop a sufficient response.

Q: Which one among the following types of ventilation, best fits the following description - "A system of ventilation in which fresh air is blown into the room by centrifugal fans so as to create a positive pressure, and displace the vitiated air" ?

Plenum ventilation. ***Plenum ventilation*** - **Plenum ventilation** involves blowing fresh air into a space using fans, creating a **positive pressure** that displaces stale air. - This method is effective for maintaining good air quality and preventing the infiltration of unconditioned air from outside. *Exhaust ventilation* - **Exhaust ventilation** involves drawing air out of a space, creating a negative pressure, which allows fresh air to enter naturally. - This method is often used to remove contaminated air from specific areas, like kitchens or bathrooms, rather than supplying fresh air to an entire room. *Balanced ventilation* - **Balanced ventilation** systems aim to supply and exhaust equal amounts of air, maintaining neutral pressure within the space. - While it uses fans for both supply and exhaust, it doesn't primarily aim to create a positive pressure and displace air as described. *Natural ventilation* - **Natural ventilation** relies on natural forces like wind pressure and thermal buoyancy to move air through a building. - It does not involve mechanical fans to blow air, nor does it typically create a controlled positive pressure to displace vitiated air.

Q: The 'Nalgonda Technique' developed by the National Environmental Engineering Research Institute (NEERI) was developed primarily for the removal of which one of the following from water ?

Fluoride. ***Fluoride*** - The **Nalgonda Technique** is a defluoridation method primarily used to remove excess **fluoride** from drinking water. - This technique utilizes the principles of chemical precipitation, adsorption, and ion exchange, using **alum** (aluminum sulfate), **lime**, and **bleaching powder** as coagulants. - Developed by NEERI to address endemic **fluorosis** in areas with high fluoride content in groundwater, particularly in regions like Nalgonda district in Telangana. *Chlorine* - Chlorine is commonly used as a **disinfectant** in water treatment to kill bacteria and viruses, not as a target for removal by the Nalgonda Technique. - Excess chlorine can be removed via activated carbon filtration or aeration, methods distinct from the Nalgonda process. *Iron* - Iron removal from water typically involves **aeration**, oxidation (e.g., with chlorine or potassium permanganate), followed by filtration. - While alum (a component of the Nalgonda Technique) can aid in iron precipitation, the Nalgonda Technique's primary design is not for iron removal. *Asbestos* - Asbestos fibers are typically removed from water using **filtration methods** like membrane filtration or granular media filtration. - The Nalgonda Technique is a chemical precipitation process not specifically designed or effective for the removal of fibrous materials like asbestos.

Q: The expected outcome of Government of India's initiative 'SUMAN' is :

Zero preventable maternal and newborn deaths. ***Zero preventable maternal and newborn deaths*** - The **SUMAN (Surakshit Matritva Aashwasan)** initiative aims to provide assured, dignified, and quality healthcare at no cost to every woman and newborn visiting a public health facility. - The ultimate goal of this comprehensive program is to eradicate all **preventable maternal and newborn deaths**, ensuring healthy outcomes for both mother and child. *Limit preventable maternal and newborn deaths to between 1 - 2%* - This percentage represents a reduction target, but not the ultimate aspirational goal of the SUMAN initiative. - The initiative's design emphasizes achieving a state where no preventable deaths occur, rather than settling for a small percentage. *Limit preventable maternal and newborn deaths to between 2 - 5%* - This range of preventable deaths is too high to be considered the desired outcome of such a comprehensive maternal and child health program. - The SUMAN initiative strives for maximum safety and care, making even 2% to 5% an unacceptable target for preventable deaths. *Limit preventable maternal and newborn deaths to between 0.5 - 1%* - While a very low percentage, this still implies that some preventable deaths would be acceptable, which contradicts the core principle of the SUMAN initiative. - The program's foundational premise is that all preventable deaths should be eliminated through quality care and intervention.

Q: Water contamination with which chemical can lead to methaemoglobinaemia?

Nitrate. ***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.

Q: Which of the following statements are correct regarding Mantoux test for tuberculosis? 1. It entails injecting 1 TU (Tuberculin Unit) of PPD (Purified Protein Derivative) in 0.1 mL intradermally. 2. The injection should be given with the needle bevel facing downward. 3. When placed correctly, the injection should produce a pale wheal of the skin, 1 - 2 mm in diameter. 4. The injection should be given with a tuberculin syringe. Select the correct answer using the code given below:

1 and 4. **1 and 4** - Statement 1 is correct: The Mantoux test involves injecting **1 TU (Tuberculin Unit) of PPD (Purified Protein Derivative)** in **0.1 mL intradermally** into the forearm, which is the standard dose and administration route. - Statement 4 is correct: A **tuberculin syringe** is specifically designed for small, precise volume injections like the Mantoux test, ensuring accurate dosing and placement. *1 and 2* - Statement 1 is correct, but statement 2 is incorrect regarding the **Mantoux test procedure**. - The needle bevel should face **upward** during intradermal injection to ensure proper placement of the PPD and formation of the wheal. *2 and 3* - Statement 2 is incorrect because the needle bevel should face **upward** for intradermal injection. - Statement 3 is incorrect because a correctly placed Mantoux injection should produce a wheal of **6-10 mm in diameter**, not 1-2 mm, indicating the PPD is in the dermis. *2 and 4* - Statement 2 is incorrect as the needle bevel should be positioned **facing upward**. - While statement 4 correctly identifies the use of a tuberculin syringe, the incorrectness of statement 2 makes this option unsuitable.

Q: Smoking is considered to be a modifiable risk factor for Coronary Heart Disease. Consider the following statements with regard to possible mechanisms on the basis of which it acts as a risk factor : 1. Nicotine stimulation of adrenergic drive raises the blood pressure and myocardial oxygen demand. 2. It increases carbon monoxide and induces atherogenesis. 3. It leads to fall in protective high density lipoproteins. 4. It reduces the apolipoprotein-B plasma levels. Which of the statements given above are correct ?

1, 2 and 3. **1, 2 and 3** - **Nicotine** in cigarette smoke stimulates the adrenergic nervous system, leading to increased heart rate, **vasoconstriction**, and elevated blood pressure, which **increases myocardial oxygen demand**. - **Carbon monoxide** from smoking binds to hemoglobin, reducing oxygen delivery to the myocardium, and also contributes to **endothelial damage** and **atherogenesis**. Smoking also **lowers HDL ("good" cholesterol)**, which normally helps remove cholesterol from arteries. *2, 3 and 4* - This option is incorrect because statement 4 is false; smoking typically **increases** apolipoprotein-B levels, associated with increased LDL cholesterol, not reduces them. - While statements 2 and 3 are correct mechanisms, the inclusion of statement 4 makes this option incorrect. *1 and 3 only* - This option is incomplete as it misses the crucial role of **carbon monoxide** in inducing atherogenesis (statement 2), which is a well-established mechanism of smoking-related CHD. - While statements 1 and 3 are correct mechanisms, the absence of statement 2 makes this option less comprehensive. *1 and 2 only* - This option omits the significant effect of smoking on **high-density lipoproteins (HDL)**; smoking is known to cause a **fall in protective HDL levels**, contributing to increased CHD risk. - While statements 1 and 2 are correct mechanisms, the exclusion of statement 3, which is also correct, makes this option incomplete.

Q: With reference to human body's requirement for proteins, they are essential because they are: 1. an important alternative source for energy during specific metabolic states. 2. the primary molecules responsible for maintenance of osmotic pressure within the extracellular compartment. 3. critical for upkeep of cell mediated immune response. 4. vital for the synthesis of certain hormones. Which of the statements given above are correct?

1, 3 and 4. ***1, 3 and 4*** - Proteins act as an **alternative energy source** through **gluconeogenesis** during specific metabolic states like starvation, providing 4 kcal/g when glycogen and fat stores are insufficient. - They are essential for **cell-mediated immunity** as they constitute antibodies, cytokines, and MHC molecules; additionally, many hormones like **insulin** and **growth hormone** are peptide-based. *2, 3 and 4* - This option incorrectly includes statement 2; **Sodium (Na+)** and chloride are the primary determinants of osmotic pressure in the **extracellular fluid (ECF)**, not proteins. - Plasma proteins specifically maintain **oncotic pressure** within the vascular space, but they do not serve as the primary molecules for general ECF osmotic balance. *1, 2 and 3* - This combination incorrectly validates statement 2, which confuses **colloid osmotic pressure** (oncotic pressure) with the overall osmotic pressure regulated by electrolytes. - While it recognizes **gluconeogenesis** and **immune function**, it misses the critical role of proteins in the synthesis of **peptide hormones**. *1, 2 and 4* - Including statement 2 is incorrect because the high concentration of electrolytes in the interstitium makes them the dominant osmotic agents, whereas protein concentration there is relatively low. - This option fails to acknowledge that **T-cell function** and immune signaling proteins are strictly dependent on protein intake, making statement 3 vital.

Question 1

Which food proteins among the following are considered to be the best and are used in nutritional studies as 'reference protein' ?

Accepted Answer

Egg proteins

Answer

Milk proteins

Answer

Legume proteins

Answer

Wheat proteins

Question 2

Consider the following statements with reference to 'trans fatty acids' :

1. They are geometrical isomers of cis-unsaturated fatty acids.

2. Though atherogenic, being unsaturated they are less so than saturated fatty acids.

3. It takes years for trans fatty acids to be flushed from the body.

4. They lower both LDL cholesterol and HDL cholesterol in the body. Which of the statements given above are correct ?

Accepted Answer

1 only

Answer

1 and 3 only

Answer

2, 3 and 4

Answer

1, 3 and 4

Question 3

Regarding active immunization against Typhoid fever, consider the following statements :

1. The typhoid polysaccharide vaccine is injectable and can be given subcutaneously or intramuscularly.
2. The typhoid polysaccharide vaccine is required to be given in two doses and administered on 0 and 7th day.
3. The typhoid oral Ty21a vaccine requires to be given in three doses on 0, 3rd and 7th days.
4. Protective immunity with typhoid vaccines is achieved immediately after the vaccine is received. Which of the statements given above is/are correct ?

Accepted Answer

1 only

Answer

2 and 3 only

Answer

1 and 2 only

Answer

1, 3 and 4

Question 4

Which one among the following types of ventilation, best fits the following description - "A system of ventilation in which fresh air is blown into the room by centrifugal fans so as to create a positive pressure, and displace the vitiated air" ?

Accepted Answer

Plenum ventilation

Answer

Exhaust ventilation

Answer

Balanced ventilation

Answer

Natural ventilation

Question 5

The 'Nalgonda Technique' developed by the National Environmental Engineering Research Institute (NEERI) was developed primarily for the removal of which one of the following from water ?

Accepted Answer

Fluoride

Answer

Chlorine

Answer

Iron

Answer

Asbestos

Question 6

The expected outcome of Government of India's initiative 'SUMAN' is :

Accepted Answer

Zero preventable maternal and newborn deaths

Answer

Limit preventable maternal and newborn deaths to between 1 - 2%

Answer

Limit preventable maternal and newborn deaths to between 2 - 5%

Answer

Limit preventable maternal and newborn deaths to between 0.5 - 1%

Question 7

Water contamination with which chemical can lead to methaemoglobinaemia?

Accepted Answer

Nitrate

Answer

Sulphide

Answer

Fluoride

Answer

Cyanide

Question 8

Which of the following statements are correct regarding Mantoux test for tuberculosis?

1. It entails injecting 1 TU (Tuberculin Unit) of PPD (Purified Protein Derivative) in 0.1 mL intradermally.
2. The injection should be given with the needle bevel facing downward.
3. When placed correctly, the injection should produce a pale wheal of the skin, 1 - 2 mm in diameter.
4. The injection should be given with a tuberculin syringe.

Select the correct answer using the code given below:

Accepted Answer

1 and 4

Answer

1 and 2

Answer

2 and 3

Answer

2 and 4

Question 9

Smoking is considered to be a modifiable risk factor for Coronary Heart Disease. Consider the following statements with regard to possible mechanisms on the basis of which it acts as a risk factor :

1. Nicotine stimulation of adrenergic drive raises the blood pressure and myocardial oxygen demand.
2. It increases carbon monoxide and induces atherogenesis.
3. It leads to fall in protective high density lipoproteins.
4. It reduces the apolipoprotein-B plasma levels. Which of the statements given above are correct ?

Accepted Answer

1, 2 and 3

Answer

2, 3 and 4

Answer

1 and 3 only

Answer

1 and 2 only

Question 10

With reference to human body's requirement for proteins, they are essential because they are:

1. an important alternative source for energy during specific metabolic states.
2. the primary molecules responsible for maintenance of osmotic pressure within the extracellular compartment.
3. critical for upkeep of cell mediated immune response.
4. vital for the synthesis of certain hormones.

Which of the statements given above are correct?

Accepted Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 2 and 4

UPSC-CMS 2023

Biochemistry

Community Medicine

Internal Medicine

Physiology