UPSC-CMS 2023 Practice Questions

Q: Consider the following disorders : 1. Delayed motor milestones 2. Spastic diplegia 3. Nyctalopia 4. Hearing defects Which of the above disorders occur as part of the spectrum of iodine deficiency disorders ?

1, 2 and 4. ***1, 2 and 4*** - **Delayed motor milestones** and **spastic diplegia** are hallmark neurological symptoms of **cretinism**, caused by severe congenital iodine deficiency. The spasticity results from pyramidal tract involvement affecting motor development. - **Hearing defects** (sensorineural deafness) are frequently observed in individuals with iodine deficiency disorders due to impaired thyroid hormone synthesis affecting inner ear development during critical developmental periods. *2, 3 and 4* - **Nyctalopia (night blindness)** is primarily associated with **Vitamin A deficiency**, not iodine deficiency. - While spastic diplegia and hearing defects are linked to iodine deficiency, the inclusion of nyctalopia makes this option incorrect. *1, 2 and 3* - This option correctly identifies delayed motor milestones and spastic diplegia as symptoms of iodine deficiency, but **nyctalopia** is an incorrect association with iodine deficiency. - Therefore, the presence of nyctalopia invalidates this choice. *1 and 3 only* - This option correctly includes **delayed motor milestones** but incorrectly includes **nyctalopia** as an iodine deficiency disorder. - It also omits other significant neurological and developmental problems like spastic diplegia and hearing defects that are part of the IDD spectrum.

Q: 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 ?

1, 2 and 3 only. ***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.

Q: Which of the following are domains (or types) of learning ? 1. Affective learning 2. Cognitive learning 3. Physiological learning 4. Psychomotor learning Select the correct answer using the code given below :

1, 2 and 4. ***Correct: 1, 2 and 4*** - The three generally recognized domains of learning are **cognitive**, **affective**, and **psychomotor**. - These domains describe the different types of learning outcomes and are used for classifying educational objectives. *Incorrect: 2, 3 and 4* - **Physiological learning** is not a standard, recognized domain of learning in educational theory. - While learning does involve physiological changes in the brain, "physiological" is not a classification for types of learning outcomes. *Incorrect: 1, 3 and 4* - This option correctly identifies affective and psychomotor learning but incorrectly includes **physiological learning** as a distinct domain. - **Cognitive learning**, which focuses on knowledge and intellectual skills, is a fundamental domain and is missing from this selection. *Incorrect: 1, 2 and 3* - This option correctly includes **affective** and **cognitive learning** but erroneously adds **physiological learning**. - It also omits **psychomotor learning**, which concerns physical skills and coordination, making it an incomplete classification of the standard learning domains.

Q: 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 :

2, 3 and 4. ***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.

Q: 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 :

1, 3 and 4. ***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.

Q: 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 :

1→3→2→4. **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.

Q: 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 :

1 and 4 only. ***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.

Q: The cost of implementation of 'Ayushman Bharat Pradhan Mantri Jan Arogya Yojana' is borne by :

Both Central Government and State Government. ***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.

Q: 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 ?

Neonatal mortality rate. ***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.

Q: If, on amniocentesis, the alpha fetoprotein is found to be elevated in the amniotic fluid (which correlates with elevated maternal serum levels), which of the following conditions is likely to be present?

Neural tube defects. ***Neural tube defects*** - **Elevated alpha-fetoprotein (AFP)** in amniotic fluid and maternal serum is a key indicator of neural tube defects like **spina bifida** or **anencephaly**. - These defects result in an open neural tube, allowing AFP to leak directly into the amniotic fluid. *Duchenne muscular dystrophy* - This is an **X-linked recessive genetic disorder** causing progressive muscle degeneration. - While it can be detected prenatally through genetic testing, it is **not associated with elevated AFP** levels. *Cardiac septal defects* - These are **structural abnormalities of the heart** (e.g., ventricular septal defect, atrial septal defect). - They are typically diagnosed via **fetal echocardiography** and do not cause elevated AFP levels. *Galactosaemia* - This is an **autosomal recessive metabolic disorder** where the body cannot properly metabolize galactose. - It is diagnosed by detecting elevated galactose or genetic testing, and **AFP levels are unaffected**.

Question 1

Consider the following disorders :

1. Delayed motor milestones
2. Spastic diplegia
3. Nyctalopia
4. Hearing defects
Which of the above disorders occur as part of the spectrum of iodine deficiency disorders ?

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1 and 3 only

Question 2

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 ?

Accepted Answer

1, 2 and 3 only

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 4 only

Question 3

Which of the following are domains (or types) of learning ?

1. Affective learning
2. Cognitive learning
3. Physiological learning
4. Psychomotor learning
Select the correct answer using the code given below :

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 3 and 4

Answer

1, 2 and 3

Question 4

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 :

Accepted Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

1, 2 and 4

Question 5

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 :

Accepted Answer

1, 3 and 4

Answer

1, 2 and 3

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 6

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 :

Accepted Answer

1→3→2→4

Answer

1→2→3→4

Answer

2→3→1→4

Answer

3→1→4→2

Question 7

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 :

Accepted Answer

1 and 4 only

Answer

2 and 3 only

Answer

1 and 2 only

Answer

3 and 4 only

Question 8

The cost of implementation of 'Ayushman Bharat Pradhan Mantri Jan Arogya Yojana' is borne by :

Accepted Answer

Both Central Government and State Government

Answer

State Government only

Answer

Private institutions only as a part of their Corporate Social Responsibility

Answer

Central Government only

Question 9

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 ?

Accepted Answer

Neonatal mortality rate

Answer

Caesarean section rate

Answer

Percentage of preterm births

Answer

Exclusive breastfeeding rate

Question 10

If, on amniocentesis, the alpha fetoprotein is found to be elevated in the amniotic fluid (which correlates with elevated maternal serum levels), which of the following conditions is likely to be present?

Accepted Answer

Neural tube defects

Answer

Duchenne muscular dystrophy

Answer

Cardiac septal defects

Answer

Galactosaemia

UPSC-CMS 2023

Community Medicine

Obstetrics and Gynecology