Community Medicine
8 questionsWhich 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 :
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 ?
With regard to lead poisoning, consider the following statements : 1. Coproporphyrin in urine is a useful screening test. 2. Hand washing before eating is an important measure of personal hygiene. 3. The use of d-penicillamine has been reported to be effective in management. How many of the statements given above is/are correct ?
A water body was inspected to look for the presence of mosquito eggs. It was observed that there were boat-shaped eggs, laid singly, not in clusters. The eggs also had lateral floats. Which one of the following diseases is most likely to be spread by the mosquito whose eggs were found ?
In the National Health Policy 2017, a target of 90 : 90 : 90 has been set for HIV/AIDS. Which among the following are targets for which a 90% level has been set as part of the National Health Policy ? 1. Proportion of couples who have safe sex 2. Proportion of people living with HIV who know their HIV status 3. Proportion of adolescents who have access to contraceptives 4. Proportion of people receiving antiretroviral therapy who have viral suppression Select the correct answer using the code given below :
The Sample Registration System (SRS), an important source of health information consists of continuous enumeration of births and deaths by an enumerator and an independent survey every six months by an investigator-supervisor. Which one of the following terms best describes this system ?
Cross-over type of study designs are those in which each subject serves as his/her own control. In which of the following conditions is a cross-over study not suitable ?
In which one of the following diseases are the source of infection and reservoir of infection the same ?
UPSC-CMS 2023 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 211: 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 212: 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.
Question 213: With regard to lead poisoning, consider the following statements : 1. Coproporphyrin in urine is a useful screening test. 2. Hand washing before eating is an important measure of personal hygiene. 3. The use of d-penicillamine has been reported to be effective in management. How many of the statements given above is/are correct ?
- A. None of the options
- B. All three (Correct Answer)
- C. 2 only
- D. 1 only
Explanation: ***All three*** - **Statement 1 is correct**: Urinary **coproporphyrin III** is a useful screening test for lead poisoning. Lead interferes with heme synthesis by inhibiting enzymes like ferrochelatase and ALA dehydratase, leading to accumulation and excretion of porphyrin precursors including coproporphyrin in urine. - **Statement 2 is correct**: **Hand washing before eating** is a critical preventive measure, especially in children. Lead dust on contaminated hands is a major route of exposure, particularly in environments with lead paint or industrial contamination. This is a key personal hygiene measure recommended by WHO and CDC. - **Statement 3 is correct**: **D-penicillamine** has indeed been reported to be effective in lead poisoning management. While **EDTA, DMSA (succimer), and dimercaprol** are more commonly used as first-line chelating agents today, d-penicillamine remains a valid chelating agent for heavy metal poisoning including lead, with documented effectiveness in medical literature. *1 only* - This option is incorrect because it ignores the validity of statements 2 and 3. - While statement 1 is accurate, **hand washing** (statement 2) is unquestionably an important preventive measure for lead poisoning. - Statement 3 is also correct as d-penicillamine **has been reported** to be effective (the statement doesn't claim it's first-line therapy). *2 only* - This option is incorrect because it ignores statements 1 and 3. - **Coproporphyrin in urine** (statement 1) is well-established as a screening test for lead exposure. - Statement 3 regarding d-penicillamine effectiveness is also correct based on medical literature. *None of the options* - This option is completely incorrect as all three statements are medically accurate. - Each statement represents correct information about lead poisoning screening, prevention, or management.
Question 214: A water body was inspected to look for the presence of mosquito eggs. It was observed that there were boat-shaped eggs, laid singly, not in clusters. The eggs also had lateral floats. Which one of the following diseases is most likely to be spread by the mosquito whose eggs were found ?
- A. Dengue fever
- B. Japanese encephalitis
- C. Chikungunya fever
- D. Malaria (Correct Answer)
Explanation: ***Malaria*** - The description of **boat-shaped eggs**, laid singly, and possessing **lateral floats** is characteristic of the *Anopheles* mosquito. - *Anopheles* mosquitoes are the primary vectors for **malaria**, transmitting *Plasmodium* parasites to humans. *Dengue fever* - Dengue fever is primarily transmitted by the *Aedes* mosquito, which lays **single, oval-shaped eggs** on water surfaces, typically in domestic containers. - These eggs lack the **boat shape** and **lateral floats** seen with *Anopheles*. *Japanese encephalitis* - Japanese encephalitis is mainly spread by *Culex* mosquitoes, which lay their eggs in **rafts** on the surface of water. - Their eggs are not boat-shaped or laid singly with lateral floats. *Chikungunya fever* - Chikungunya fever is transmitted by *Aedes* mosquitoes (similar to dengue), which lay their eggs **singly** on the sides of containers above the water line. - The eggs are **oval** and do not have the distinct boat-shape or lateral floats of *Anopheles*.
Question 215: In the National Health Policy 2017, a target of 90 : 90 : 90 has been set for HIV/AIDS. Which among the following are targets for which a 90% level has been set as part of the National Health Policy ? 1. Proportion of couples who have safe sex 2. Proportion of people living with HIV who know their HIV status 3. Proportion of adolescents who have access to contraceptives 4. Proportion of people receiving antiretroviral therapy who have viral suppression Select the correct answer using the code given below :
- A. 1 and 4
- B. 1 and 3
- C. 2 and 3
- D. 2 and 4 (Correct Answer)
Explanation: ***2 and 4*** The **90-90-90 targets** for HIV/AIDS established by UNAIDS and adopted in India's National Health Policy 2017 have three specific goals: - **First 90**: 90% of all people living with HIV know their HIV status - **Second 90**: 90% of all people diagnosed with HIV receive sustained antiretroviral therapy (ART) - **Third 90**: 90% of all people receiving ART achieve viral suppression **Statement 2** correctly identifies the **first 90** (proportion of people living with HIV who know their status), and **Statement 4** correctly identifies the **third 90** (proportion on ART achieving viral suppression). *1 and 4* While promoting safe sex is crucial for HIV prevention, the **90-90-90 targets specifically focus on the cascade of diagnosis, treatment, and viral suppression** among people already living with HIV. The proportion of couples having safe sex is not part of these specific targets. *1 and 3* Neither the **proportion of couples having safe sex** nor **adolescent access to contraceptives** are part of the 90-90-90 targets for HIV/AIDS. These are important broader public health goals but not the precise metrics of the 90-90-90 HIV strategy. *2 and 3* While **Statement 2** (proportion knowing their HIV status) is indeed the first component of the 90-90-90 targets, the **proportion of adolescents with access to contraceptives** is not part of these HIV-specific targets. This is a separate reproductive health goal unrelated to the 90-90-90 framework.
Question 216: The Sample Registration System (SRS), an important source of health information consists of continuous enumeration of births and deaths by an enumerator and an independent survey every six months by an investigator-supervisor. Which one of the following terms best describes this system ?
- A. Triple-record system
- B. Double blinding
- C. Double data entry
- D. Dual-record system (Correct Answer)
Explanation: ***Dual-record system*** - This system involves two independent sources of data collection, such as a continuous enumeration and a periodic survey, to estimate vital events with greater accuracy by **cross-checking and matching the records** - The independent enumeration by an enumerator and a separate survey by an investigator-supervisor perfectly aligns with the principles of a **dual-record system**, designed to improve data quality and completeness - The SRS uses this methodology to capture births and deaths that might be missed by a single source *Triple-record system* - This system would involve **three independent sources** of data collection, which is more complex and not described in the given scenario - While potentially offering even higher accuracy, it's not applicable here as only two sources are mentioned *Double blinding* - **Double blinding** is a technique used in clinical trials where neither the participants nor the researchers know who is receiving a particular treatment - This method is used to **prevent bias** in clinical studies and is completely unrelated to vital statistics data collection methodology *Double data entry* - **Double data entry** is a process where data is entered twice by two different operators and then compared to **identify and correct errors** - This technique focuses on improving the accuracy of data input for a single data source, not on combining two independent sources of information for surveillance
Question 217: Cross-over type of study designs are those in which each subject serves as his/her own control. In which of the following conditions is a cross-over study not suitable ?
- A. If the disease changes radically during the period of time required for the study
- B. None of the options
- C. If the drug is effective during all stages of the disease
- D. If the drug of interest cures the disease (Correct Answer)
Explanation: ***If the drug of interest cures the disease*** - A **crossover study** relies on subjects experiencing both treatment and control conditions, which is **not possible** if a drug cures the disease, as the initial treatment would eliminate the condition for the second phase. - The carryover effect of a cure would invalidate the comparison between the treatment and control periods, making subsequent observations on the same subject non-independent. *If the disease changes radically during the period of time required for the study* - **Radical changes in disease progression** would introduce significant **confounding variables**, making it difficult to attribute changes in outcome solely to the intervention. - The **baseline state** for the second treatment period would be vastly different from the first, violating the assumption of comparable conditions inherent in crossover designs. *None of the options* - This option is incorrect because there is a specific scenario among the choices where a crossover study is unsuitable, as detailed in the correct answer. *If the drug is effective during all stages of the disease* - A drug's effectiveness across all disease stages would actually **make a crossover study more suitable**, as the treatment effects could be consistently observed regardless of when the intervention is given. - This scenario would reduce the variability in response due to disease progression, allowing for a clearer comparison between treatment and control periods.
Question 218: In which one of the following diseases are the source of infection and reservoir of infection the same ?
- A. Tetanus
- B. Hookworm infection (Correct Answer)
- C. Cholera
- D. Typhoid
Explanation: ***Hookworm infection*** - In hookworm infection, the **infected human host** is considered both the **source** and **reservoir** of infection in the epidemiological chain. - The adult worms live in the **human intestine** (reservoir), and humans excrete eggs in feces that contaminate soil, where larvae develop and subsequently infect other humans, perpetuating the cycle within the human population. - While larvae develop in soil, the **ultimate source and reservoir is the infected human**, as without human hosts, the transmission cycle cannot be maintained. *Tetanus* - The **reservoir** for tetanus is **soil and the gastrointestinal tract of animals**, where *Clostridium tetani* spores persist. - The **source of infection** is contaminated soil or rusty objects entering wounds. - Humans are **accidental hosts** (dead-end hosts) and do not serve as reservoirs, so source and reservoir are distinct (both environmental). *Cholera* - The **reservoir** for cholera is primarily **humans**, with *Vibrio cholerae* colonizing the intestinal tract. - The **source of infection** is typically **water or food contaminated with feces** from infected individuals. - While humans are the main reservoir, aquatic environments can serve as secondary environmental reservoirs, and the immediate source (contaminated water/food) is often considered distinct from the human reservoir in classical teaching. *Typhoid* - The **reservoir** for typhoid is exclusively **humans**, particularly chronic carriers who harbor *Salmonella typhi* in the gallbladder. - The **source of infection** is **food or water contaminated** by infected human carriers. - Although humans are the sole reservoir, the immediate source (contaminated food/water) is conventionally distinguished from the reservoir (the carrier), making them technically distinct in the transmission chain.
Internal Medicine
1 questionsWhich of the following statements are correct regarding Chikungunya fever ? 1. It is usually transmitted by Culex mosquito. 2. A safe and effective vaccine is available for commercial use. 3. Incubation period is 4 - 7 days. 4. One of the prominent symptoms is arthropathy. Select the correct answer using the code given below :
UPSC-CMS 2023 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 211: Which of the following statements are correct regarding Chikungunya fever ? 1. It is usually transmitted by Culex mosquito. 2. A safe and effective vaccine is available for commercial use. 3. Incubation period is 4 - 7 days. 4. One of the prominent symptoms is arthropathy. Select the correct answer using the code given below :
- A. 1 and 4 only
- B. 3 and 4 only (Correct Answer)
- C. 2 and 3 only
- D. 1 and 2 only
Explanation: ***3 and 4 only*** - The incubation period for Chikungunya fever is typically **3-7 days**, with a range of 2-12 days, making 4-7 days a correct estimate. - **Arthropathy** (severe joint pain and swelling) is a hallmark symptom of Chikungunya fever, often presenting with polyarthralgia that can be debilitating and chronic. *1 and 4 only* - Chikungunya fever is primarily transmitted by **Aedes mosquitoes** (Aedes aegypti and Aedes albopictus), not Culex mosquitoes. - While arthropathy (statement 4) is a correct symptom, the transmission by Culex mosquito (statement 1) is incorrect. *2 and 3 only* - As of now, there is **no commercially available safe and effective vaccine** for Chikungunya fever, although several are in clinical trials. - While the incubation period (statement 3) is correct, the absence of a commercially available vaccine (statement 2) makes this option incorrect. *1 and 2 only* - Chikungunya is transmitted by **Aedes mosquitoes**, not Culex mosquitoes. - There is currently **no licensed vaccine** for Chikungunya available for widespread commercial use.
Pathology
1 questionsWhich among the following has two general phases - first, simple pneumoconiosis and a second phase characterized by progressive massive fibrosis (PMF)?
UPSC-CMS 2023 - Pathology UPSC-CMS Practice Questions and MCQs
Question 211: Which among the following has two general phases - first, simple pneumoconiosis and a second phase characterized by progressive massive fibrosis (PMF)?
- A. Bagassosis
- B. Anthracosis (Correct Answer)
- C. Byssinosis
- D. Siderosis
Explanation: ***Anthracosis (Coal Worker's Pneumoconiosis)*** - **Coal Worker's Pneumoconiosis (CWP)**, also known as **anthracosis** or **black lung disease**, is caused by prolonged inhalation of **coal dust** [1]. - It characteristically progresses through **two distinct phases** [2]: - **Simple CWP (Simple Pneumoconiosis)**: Characterized by coal macules and nodules (<1 cm) visible on chest X-ray, usually asymptomatic [2]. - **Complicated CWP (Progressive Massive Fibrosis - PMF)**: Large confluent fibrotic masses (>1 cm), often in upper lobes, leading to significant respiratory impairment [1][2]. - **PMF develops in 10-15%** of cases with simple CWP and represents irreversible progressive fibrosis. *Bagassosis* - **Bagassosis** is a **hypersensitivity pneumonitis** (extrinsic allergic alveolitis) caused by exposure to **bagasse**, the fibrous residue of sugarcane containing thermophilic actinomycetes [1]. - It presents as an **acute or chronic inflammatory response**, not a two-phase pneumoconiosis with PMF. *Byssinosis* - **Byssinosis** is an occupational lung disease caused by exposure to **cotton, flax, or hemp dust** in textile workers. - It manifests as **reversible airway obstruction** with characteristic **"Monday morning" chest tightness** and does not progress to PMF. - It is a reactive airway disease, not a fibrotic pneumoconiosis. *Siderosis* - **Siderosis** is a **benign pneumoconiosis** caused by inhalation of **iron oxide particles** (welders, iron miners) [1]. - It causes **radiographic opacities** but is **non-fibrogenic** and does not cause functional impairment or progress to PMF [1]. - Iron particles are inert and do not trigger significant inflammatory or fibrotic response. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 695. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 331-332.